From managing 100+ disparate lab relationships to driving same-store growth with a strategic partnership
Summary of Impact:
APEX Dental Partners needed to consolidate their lab strategy from 100+ clinician-owned relationships, to a few trusted national lab providers.
They chose Dandy because they liked the emphasis on partnership, technology, clear clinical impact and the zero upfront cost.
Since choosing Dandy, they’ve been able to:
- Project a 12.5% increase in annualized revenue
- Reduce remake rate by 29%
- Eliminate tens of thousands in CAPEX with zero upfront cost
- Decrease denture appointments by 50%
- Unlock new revenue from previously unprofitable procedures like dentures
For APEX Dental Partners, a rapidly growing DSO based in Dallas, Texas, lab consolidation was more than an operational necessity—it was a strategic imperative for sustainable growth.
With 59 offices across multiple states, APEX faced the classic DSO dilemma: how to balance clinical autonomy with the operational efficiency needed to scale. Each practice was working with three to seven different labs, creating a fragmented network that made it nearly impossible to leverage volume pricing, maintain quality standards, or gain visibility into performance.
“We had a lot of lab partnerships that weren’t national lab brands, ” explained Dr. Michael Fooshée,Chief Clinical Operations Officer at Apex Dental Partners. “What we realized is that it led to challenges supporting our clinicians, especially as we expanded into new markets.”
The fragmentation created multiple pain points that were limiting Apex’s ability to grow:
No negotiating power. “If we have every single dentist choosing their own lab, we never have a volume advantage, ” Dr. Fooshée noted. Without consolidated spend, APEX couldn’t capture the cost savings their scale should have provided.
Operational complexity. It was impossible to consolidate billing processes with multiple lab partners. Each lab partner had their own invoicing processes creating difficulty for the APEX operations team.
Limited clinical support. The APEX operations team had limited ability to support their clinicians without a direct line of communication to many of their other labs.. In addition, they couldn’t rely on the labs to enable clinicians to provide high-quality work with fewer remakes.
Zero visibility. Dr. Brad Eller, Director of Clinical Development said, “I didn’t have a lot of interaction with the labs because there were so many different ones. I didn’t know who people were using. I had no way of really tracking as to how things were going. I had nobody I could give feedback to. I was out of the loop, basically. “
The Solution: A Partnership Model Built on Clinical Autonomy and Strategic Alignment
APEX needed a different approach—one that wouldn’t alienate their providers but would deliver the operational benefits of consolidation. Their answer was a carefully curated lab portfolio that balanced national reach, clinical autonomy, and digital innovation.
That’s where Dandy entered the picture.
Dr. Fooshée explained. “The reason I ended up really pushing ahead with the partnership with Dandy was their focus on the technology component, which helps our clinical team support our doctors.”
But technology alone wasn’t enough. Dr. Layla Lohmann, Co-Founder and Clinical Director at APEX, was clear about their requirements: “I wanted to give our doctors guided choices, thoughtful choices. We’ve done the research for them and been solution-focused. ” They needed to provide clinicians with choices that made sense based on costs, services and ease-of-use.
Why Dandy Aligned with APEX’s Strategic Vision
Several factors made Dandy the right fit:
Shared values on partnership. We share the same values, ” Dr. Lohmann told the Dandy team. “You care about people, you care about education. You don’t just get mad at a partner if we don’t do it right the first time. It’s a collaborative approach. “
Technology-first mentality. “You’re really tech-driven, and I think in the industry now, those who are not tech-forward are going to be left behind at some point, ” she emphasized. For a DSO positioning itself as “private practice reimagined, ” staying ahead of the technology curve wasn’t optional; it has been a part of their promises to their providers.
Clear clinical value. Dandy’s value was strong enough that doctors wanted to adopt it. “I’m not having to sell the product to my doctors, ” Dr. Fooshée noted. “Dandy’s already created a good business model that makes sense. “
Zero capital investment. With Dandy providing free scanners, APEX eliminated a major barrier to digital adoption while freeing up capital for other growth initiatives. The total value of scanners Dandy has placed so far is $1.5m and rising. Dr. Eller says, “With other national lab brands you’re looking at $35,000 to $75,000 just to have a scanner in your office. The fact is that there is zero cost to bring in a Dandy scanner, and you get a lab credit to try it out. It’s a no-lose situation. “
Implementation: Building Momentum Through Provider Buy-In
APEX’s approach to implementation reflected their philosophy of guided choice rather than mandated compliance. “We have been focused on supporting doctor autonomy with lab selection, ” Dr. Fooshée explained.
Instead, APEX positioned Dandy as the obvious choice—backed by compelling value propositions:
- Free scanners to decrease the barrier to entry for clinicians
- Competitive pricing that leveraged APEX’s consolidated volume
- Superior support compared to other national labs
- Technology advantages including digital workflows that increase case acceptance
- Live chairside support for newer doctors and recent graduates
“For most doctors, the free scanner is the number one thing that initially gets them interested, ” Dr. Fooshée shared. “But it’s all the other things that doctors are staying for. ”
Dr. Lohmann added: “When I’m speaking to skeptical doctors, I talk about how the technology allows faster communication. If I have a question about a fixed unit, I can get to chat live with a Dandy representiatve a lot quicker than calling thelab on the phone. The accessibility is quicker and the response time saves me and my team time in “real time” ” .
Dandy’s commitment to relationship-building accelerated adoption. “One of the things that stood out in the relationship-building process and the launch was Dandy’s willingness to invest in getting themselves in front of our doctors and teams, ” Dr. Fooshée recalled. “That’s been impressive—their commitment to invest in the relationship from the beginning.”
Results: Consolidation, Cost Savings, and Clinical Excellence
The partnership has delivered measurable impact across multiple dimensions of APEX’s business:
1. Free Up Chair Time to See More Patients
Dramatic reduction in denture appointments. Dr. Lohmann completed her first dentures in seven years using Dandy’s digital workflow. “I remember it used to take me seven or eight appointments originally, and this took four. It really reduced the patient’s time away from their family and work. ”
Even more impressive: “With the right training, most of the digital denture workflow can be handled by a skilled RDA from scanning to initial fitting. I educate the patient first, then my assistant carries the process forward, and I step back in to confirm borders, function, and esthetics. Training our RDAs on the technology has been a game changer. It’s reduced chair time, improved efficiency, and made removable a predictable solution for patients who need function. ”
Eliminated scanner bottlenecks. “I have a pretty consistent request for scanners from offices, and that’s essentially gone away because for offices that have the request—Dandy is the answer, ” Dr. Fooshée explained. “Coming into the end of the year, we’d normally be receiving dozens of requests for new scanners, but now practices have a more affordable pathway to increased scanning capacity. “
AI-powered efficiency. Dr. Lohmann noted how Dandy’s AI margin detection saves time: “My dental assistants normally wait for me to mark all my margins. In the last three cases, my RDAs check and see if the AI has any detections, and if not, we process it. I haven’t double-checked the AI-generated margins, so it’s gained me time. At delivery, we have been impressed with the accuracy in the pre-seat xrays”
2. Turn More Treatment Plans Into Accepted Cases
Technology improves patient education. “We do wellness scans on all our new patients, and they get amazed at the technology we’re using, ” shared one APEX provider. “Showing patients a scan of their teeth makes it easier to recommend treatment. ”
Enhanced patient comfort. “The wand is smaller, so it helps with patient comfort for those with bad gag reflex and limited openings, ” Dr. Lohmann explained.
Digital preview builds confidence. The ability to review digital wax-ups before production gives both clinicians and patients confidence in the final result.
3. Expand Offerings to Capture More Revenue Per Patient
Digital dentures unlock new revenue. “What’s exciting about this is that doctors are getting excited about doing dentures again, which is a very hard thing to do, ” Dr. Fooshée noted. “Dandy’s digital denture workflow puts these at a price point that actually starts to make sense for the office again. ”
Complex cases made accessible. Dr. Lohmann successfully completed a roundhouse bridge— “only my fourth in 14 years” —with Dandy’s support.
4. Leverage Data to Uncover New Growth Opportunities
Hub dashboard provides unprecedented visibility. “The Dandy Hub gives me one place I can go in and I can look at any doctor’s scan and prep. I can look at who is getting remakes and why. I can see who is ordering, who is not ordering. It has simplified my part of the process greatly, ” said Dr. Eller
Proactive clinical support. Dr. Eller highlights Dandy’s technology in helping new clinicians drive better results, faster. “I’ve been able to see some of the preps where they’re not getting the tissue before they take the scan. ” That leads to a direct conversation with them about what they could do differently or better to get better results. Some of those things would normally take five years of trial and error to figure out how to do them well. With Dandy, we’re fast-tracking their progress and getting them to a point where they get good results. “
5. Build a Culture That Drives Alignment and Growth
Lab as team member, not vendor. Dr. Lohmann emphasized the cultural shift: “For any DSO relationship or clinician, I would ask them to think about any lab as a true partnership. Communication is vital before you throw people under the bus. Dandy is a great partner—it’s about moving away from how vendors are traditionally seen versus having a strategic partnership. ”
Empowered dental assistants. “Dandy has allowed us to elevate the role of our RDAs in a meaningful way. When the lab clearly communicates what’s needed and we train our assistants on the digital workflow; they step into greater ownership of the case. That builds confidence, skill, and career growth. If we want our team members to grow professionally and increase their value, we have to give them the tools, training, and trust to operate at that next level.
Consolidated clinical support. By standardizing the majority of practices on Dandy, APEX created a replicable clinical support model that scales across their organization.
Financial Impact
- Saved >€1.5 million in intraoral scanner costs
- Eliminate annual scanner CAPEX that previously ran into the tens of thousands of dollars
- Consolidate lab partnerships from 100+ labs down to a targeted 10
- Increase practice efficiency through reduced chair time, digital workflows and fewer remakes
- Attain zero remakes by several providers after a year of use
- Offer new revenue streams and increase ROI from previously unprofitable procedures like dentures
Looking Ahead: Continued Innovation and Growth
As APEX continues to scale, the partnership with Dandy remains central to their growth strategy.
“I’m excited that they continue to prove they’re not done innovating, ” Dr. Fooshée shared. “Within four or five months, they’ve continued to innovate, which is exciting. I’m interested to see what happens next. “
Advice for Other DSOs
When asked what he would tell another DSO executive considering Dandy, Dr. Fooshée didn’t hesitate: “It’s a no-brainer. If you don’t want to be in a position where you have to talk doctors into switching labs, this is the easiest pathway to lab consolidation. Dandy has the team to do it. They understand the approach that works, and they havea track record of getting consolidation accomplished. ”
Dr. Lohmann added, “If you want to learn with a lab on how to do things effectively, that’s the partnership I would recommend. They’re very easy to communicate with. You want to get in early with a company that’s growing so you can grow together and learn together instead of just switching lab after lab. ”
Dr. Eller gave his own advice, “Explore the Dandy Hub. If you’re just in there to look at a scan, you’re missing out on so many different opportunities. There is a wealth of knowledge and information that’s in there if you take the time to go through.”
The Bottom Line: From Cost Center to Revenue Engine
For APEX Dental Partners, the partnership with Dandy has fundamentally transformed how they think about their lab relationships. What was once viewed primarily as an operational complication and expense is now recognized as a strategic lever for same-store growth.
As Dr. Lohmann put it: “Dandy is an organization that values education, technology, and people—three things in the healthcare industry that need attention. They help refocus on how to be solution-oriented and receive feedback well, then figure out a way to get you that next elevation or next solution. ”
For DSOs facing the same pressures APEX encountered—slower M&A pipelines, margin compression, the need to drive same-store growth—the lesson is clear: your dental lab partner shouldn’t just be reducing costs. With the right partner, your lab can unlock new revenue, improve clinical outcomes, and become a true competitive advantage.
