What a dental startup consultant costs depends on how they are paid: a flat fee, a percentage of the project, an hourly rate or retainer, or "free" help funded by the equipment order, the loan or the lease. Alithos Advisory publishes its fees: $2,500 for the Feasibility Check, $7,500 to $10,000 for the Budget Plan, and from $20,000 for Project Navigator (availability depends on your project's state). Whoever you hire, get how they are paid in writing.
It's a fair question to ask on an advisory firm's own blog. So I'll answer it the way I'd answer anything about your project: show how the money moves, put my own prices on the table, and tell you plainly when you shouldn't hire anyone at all.
The stakes are why this matters. An ADA News expert column says opening a dental practice often takes $500,000 at minimum1. The Alithos planning model puts a 4–5 operatory startup in leased space at standard finish at about $746,000 to $980,000 all-in, including working capital (see the benchmark5; planning math, not a quote). On a project that size, the way your advisor is paid shapes the advice you get. For the full picture of who can plan a dental office, read dealer design, design-build, consultant or independent planner compared.
How are dental startup consultants paid?
There are six common ways. I'm not going to quote market prices for other firms. I haven't found a reliable public source for them, and not every firm publishes its fees. What I can show you is the incentive each model creates, because that is what you are really buying.
| Fee model | How it works | Incentive it creates | What to ask |
|---|---|---|---|
| Flat fee | One fixed price for a defined scope, agreed before work starts | Deliver the scope; no stake in how big your project gets | What exactly is in scope, and what triggers a change in fee? |
| Percentage of project | Fee is a share of construction or total project cost | A bigger project means a bigger fee | A percentage of which number? Is it capped? Does it fall if I cut scope? |
| Hourly or monthly retainer | Billed by the hour or by the month for as long as you engage | A longer engagement pays more | What is your estimate of total hours or months, and is there a cap? |
| Bundled program | A package covering many steps over the life of the project | Sell the whole bundle; pieces are hard to price separately | Can I buy just the budget and plan? What does each piece cost? |
| "Free," vendor-funded | Dealer design, lender project managers, tenant-rep brokers | Paid when you buy, borrow or sign | Who pays you, how much, and at what event? |
| Referral-funded | The advisor is paid by vendors they recommend to you | Steer you to whoever pays the referral | Will you disclose, in writing, every payment from anyone I hire? |
None of these models makes a person dishonest. Good people work under all of them. But the model tells you which way the pressure runs when a decision is close.
What a percentage fee does to a scope decision
Here is the arithmetic, using the Alithos model and a hypothetical 3% rate picked only to make the math easy. It is not a market rate.
| Scenario (Alithos model, point estimate) | Project total | Hypothetical 3% fee | Flat fee |
|---|---|---|---|
| 5 ops, lease, standard finish | $933,500 | $28,005 | Unchanged |
| 5 ops, lease, premium finish + CBCT | $1,236,000 | $37,080 | Unchanged |
| Difference | $302,500 | +$9,075 | $0 |
Under a percentage fee, the upgrade to premium finish and CBCT raises the advisor's pay by $9,075. Under a flat fee, it raises nothing. That doesn't mean the upgrade is wrong. Some practices need it (I wrote about when CBCT pays its way). It means you want the person helping you decide to have nothing riding on the answer.
What does Alithos charge, and what does each fee buy?
Not every firm publishes its fees. Here are mine. Every fee is flat, paid by you alone, with no commissions, referral fees or kickbacks from lenders, dealers, brokers or contractors, in either direction.
| Service | Fee | What it buys | When it fits |
|---|---|---|---|
| Feasibility Check | $2,500 flat; credits toward the Budget Plan | Go / no-go financial screen, space and site fit, a high-level equipment budget range, and a DSCR pre-check against the 1.25× standard lenders commonly look for | You have a site or an idea and want to know if it holds up before spending more |
| The Budget Plan | $7,500–$10,000 flat; exact fee and scope set in writing before work starts | Space requirements, a line-item equipment and imaging budget, build vs. lease vs. condo projections, Section 179 and tax modeling, cash-flow and debt-service coverage analysis, and a lender-ready package | You are committed to a startup, relocation or build and need the full number before you sign anything |
| Project Navigator | From $20,000, quoted per project | Everything in the Budget Plan, plus owner-side advisory through opening: independent quote review, floor plan and design review against the budget, lender negotiation support, budget tracking and change-order review | You want an independent check on every quote and change order until opening day. Availability depends on your project's state; confirmed before engagement |
Most Budget Plans are completed in 3–5 weeks from kickoff, depending on how quickly we gather your production and financial data. In the Alithos model, a 4-operatory lease startup at standard finish runs about $746,000 to $824,000. A $7,500–$10,000 Budget Plan is about 0.9% to 1.3% of that, and the fee stays the same if the project grows.
I don't sell equipment, construction, real estate or loans. I'm not a contractor, architect, engineer, real estate broker, lender, attorney, CPA or investment adviser. You keep your own team. The plan gives all of them the same verified numbers, and your attorney and CPA still review what they should. See all three services side by side on the services page.
Who pays for "free" help?
Most dental office projects come with offers of free help. None of it is free. It's priced into the equipment order, the loan, the lease or the construction contract. Here is the conflict map.
| Who | What they offer | How they're paid | Whose side? |
|---|---|---|---|
| Equipment dealer design team | "Free" office design and equipment planning | Margin on the equipment order | The sale's |
| Lender project manager | "Free" project coordination | Interest on the loan | The bank's |
| Tenant-rep broker | "Free" site search | Commission paid at lease signing | The closing's |
| Design-build firm | Bundled design and construction | Profit on the build it scopes | The build's |
| Flat-fee independent planner | A budget plan, paid for directly | A fee you can see, paid by you | Yours |
Notice the pattern. Each no-cost advisor above is paid by the size or the closing of your transaction. That doesn't make them villains. Dealer designers and lender project managers do useful work. It makes them salespeople, and the right way to work with a salesperson is with your own number already in hand. I explain how dealer design gets paid for in the "free" office design isn't free, and how bundled contracts compare in design-build vs. design-bid-build.
Incentives in this industry are a matter of public record, not just theory. In 2019 an FTC administrative law judge ruled that two of the largest dental distributors had conspired to refuse discounts to dental buying groups2. Henry Schein was not held liable. That case says nothing about any dealer's conduct today. It does show why a buyer should price-check, whoever they buy from.
When don't you need a consultant?
Honest answer: often. If you're buying a healthy practice with clean books, keeping the space as it is, and you have a dental CPA and attorney on the deal, a project consultant adds little. Spend the money on working capital instead (here's how much working capital to plan for). The trade-offs between the two paths are in startup vs. acquisition.
You also may not need one if you have built an office before, you know your market's costs, and you're comfortable reading a lender's term sheet, a lease and a contractor's bid side by side. Plenty of dentists do this well on their own. Ownership is still the norm in dentistry: the ADA Health Policy Institute reports that 72.5% of U.S. dentists were private-practice owners in 20233. Owning a practice does not require hiring a consultant.
A consultant earns the fee where the facility is the project: startups, relocations, expansions and ground-up builds. That's where six-figure construction and equipment decisions stack up faster than a working dentist can check them. If that's you, start with the step-by-step guide to opening a dental practice and the startup checklist, then decide which steps you want help with.
If you can't yet state your all-in project number, your monthly debt service, and the collections it takes to cover that payment at 1.25×, you need that answer before you sign a lease or a loan. You can get a first pass free from the cost estimator. Whether you then hire anyone is up to you.
How do you buy advice, whoever you hire?
These rules apply to me as much as anyone.
- Ask for the price before the sales call. If an advisor won't name a fee until after a "discovery call," ask why. A published price is a sign the scope is defined.
- Ask how they're paid, in writing. The cleanest answer is "by you, a flat fee, no commissions in either direction." Anything else can still work, but you should know it.
- Ask what they don't do. Real advisors have edges. "We handle everything" usually means the margin is somewhere you can't see.
- Ask for the deliverable list. A plan you can hand a lender, a contractor and an equipment rep is worth paying for. A pep talk isn't.
- Separate advice from purchases. Buy the plan from one party and the equipment, construction and loan from others. That way each one checks the next.
Questions worth sending by email before you sign any engagement letter:
- Do you receive any payment, credit or referral fee from a lender, dealer, contractor, broker or landlord connected to my project?
- If my project budget goes up or down by $100,000, does your fee change?
- What is the total I should expect to pay you, start to finish?
- Can I see a sample deliverable with client details removed?
- Which licensed professionals (attorney, CPA, architect) will I still need?
- What happens to the fee if I decide not to go ahead?
Lenders underwrite the numbers you bring. For SBA 7(a) loans, the SBA sets the program limits (up to $5 million) and terms4, but the budget behind the request is yours to defend. That's why the plan should exist before the loan application, not after it.
What should a dental startup consultant deliver?
Whoever you hire, these are the things you should be able to hold in your hand at the end. If an advisor can't commit to most of them in writing, keep looking.
- An all-in project budget, line by line: space, construction, equipment, imaging, cabinetry, IT and furniture, soft costs and working capital
- The square footage and operatory count, tied to your production plan
- A comparison of lease, build and condo paths where they apply
- Monthly debt service and the collections needed to cover it at the coverage ratio lenders commonly look for
- A lender-ready package your bank can underwrite from
- A list of what's excluded and what assumptions each number rests on
- Tax items flagged for your CPA to confirm, not tax advice
- Lease and contract issues flagged for your attorney to review, not legal advice
- A written statement of how the advisor was paid on your project
Then use it. Get your full project number verified before you sign anything. Whether I build that number or you do, it's the decision that decides the rest.
Frequently asked questions
How much does a dental startup consultant cost?
It depends on the fee model. Consultants charge flat fees, a percentage of the project, hourly rates or retainers, or work "free" because a dealer, lender or broker pays them out of the transaction. Not every firm publishes its prices. Alithos Advisory does: $2,500 for the Feasibility Check, $7,500 to $10,000 for the Budget Plan, and from $20,000 for Project Navigator, where availability depends on your project's state.
Is a percentage-of-project fee a conflict of interest?
It creates one, even when the advisor is honest. If the fee is a share of project cost, every upgrade or added square foot raises the advisor's pay. At a hypothetical 3% rate, moving a 5-operatory lease project in the Alithos model from standard finish to premium finish with CBCT would raise the fee by $9,075. A flat fee does not change with scope.
Do I need a consultant to open a dental practice?
No. Many dentists open or buy practices without one. A consultant adds the most where the facility is the project, such as a startup, relocation or ground-up build, and the least on a clean acquisition in a space you keep as it is. Either way, know your all-in project number before you sign a lease or a loan.
What does Alithos Advisory charge?
The Feasibility Check is $2,500 flat and credits toward the Budget Plan. The Budget Plan is a flat $7,500 to $10,000, with the exact fee and scope set in writing before work starts. Project Navigator starts at $20,000 and is quoted per project; availability depends on your project's state and is confirmed before engagement. There are no commissions or referral fees.
Do dental consultants take referral fees?
Some advisors are paid by the lenders, dealers, contractors or brokers they recommend, and some are not. The only way to know is to ask, in writing, whether they receive any payment, credit or referral fee from anyone connected to your project. Alithos Advisory takes no commissions, referral fees or kickbacks from anyone, in either direction.
What should a dental startup consultant deliver?
At minimum: a line-item, all-in project budget including working capital, the square footage and operatory count tied to your production plan, monthly debt service and the collections needed to cover it, a lender-ready package, and a list of exclusions and assumptions. Tax and legal items should be flagged for your CPA and attorney, not decided by the consultant.
How we research and update this page. Alithos fees come from this site and are exact. Model figures come from the Alithos estimator and are planning math, not quotes. No other firm is named or priced. Market facts come from the sources below. Read the editorial policy.
Sources
- ADA News, M. Jerkins, "Ask the Expert: How to be financially prepared for practice ownership" (2025). adanews.ada.org
- Federal Trade Commission, In re Benco Dental Supply Co. et al., Docket No. 9379, Initial Decision (2019). ftc.gov
- ADA Health Policy Institute, Dental practice research (accessed 2026). ada.org
- U.S. Small Business Administration, 7(a) loans (accessed 2026). sba.gov
- Alithos Advisory, dental office cost benchmark and estimator methodology (2026). alithos.co
Start free: run the cost estimator, or book a free Project Fit Call and ask me anything on that list, including how I'm paid.