North Carolina Ends DSO Preapproval Requirement
This Southern state has eliminated its DSO management agreement preapproval process, streamlining transactions while preserving key compliance requirements under the Dental Practice Act.
Dental service organizations (DSOs), investors, and practice owners in North Carolina will benefit from a significant regulatory change that took effect on July 7, 2026. The state has eliminated the long-standing requirement that DSO management arrangements be submitted to the North Carolina State Board of Dental Examiners for review and approval prior to execution.
The change is expected to reduce administrative delays, lower transaction costs, and provide greater certainty for dentists and DSOs pursuing new affiliations or ownership transitions. The board has also confirmed that management arrangements already under review will be closed without further action.
While the preapproval requirement has been removed, dentists should not assume that oversight has ended. The board retains the authority to investigate management arrangements in response to complaints and may review existing agreements for compliance with the North Carolina Dental Practice Act.
Management services agreements must still be written, signed by all parties, clearly define the services provided, specify the duration of the arrangement, and outline compensation or the methodology used to calculate it. Existing prohibitions, including restrictions on percentage-based management fees and succession agreements, also remain in effect. Click here to read more.
