# Dental practices in Spokane, WA: a founder's guide to running & growing your business

ITEX brings your dental practice new customers from a local trade network and lets you cover real expenses without spending cash — growth in the busy months, a cushion in the slow ones. This guide covers running and growing a dental practice in Spokane, WA; ITEX is one option woven inside it.

> ITEX — Turn unused business capacity into trade dollars — without discounting.

## The Spokane, WA market for dental practices
Spokane is the commercial hub of the Inland Northwest. The Spokane-Spokane Valley, WA metro held about 605,000 residents in 2024 (604,962 on the 2024 American Community Survey) 1, and metro output reached roughly $39.7 billion in 2023 on the U.S. Bureau of Economic Analysis series carried by FRED 2. Health care anchors the economy: Greater Spokane Incorporated reports that four of Spokane County's twelve largest employers are health-care institutions — Providence Inland Northwest Washington, MultiCare Health System, the Mann-Grandstaff VA Medical Center, and CHAS Health 3. Tourism is a second engine, with Spokane County drawing a record 10.2 million visitors and about $1.55 billion in visitor spending in 2025 4. Growth concentrates in named districts — the redeveloped Kendall Yards, roughly 78 acres on the north bank of the Spokane River 5, and the University District east of downtown, home to WSU Spokane and its Elson S. Floyd College of Medicine across the river from Gonzaga University 6. Confirm any program terms with Greater Spokane Incorporated before relying on them.

- [Greater Spokane Incorporated — the Heart of Spokane's Economy](https://greaterspokane.org/economic-development/the-heart-of-spokanes-economy/)
- [City of Spokane — Economy and Major Employers](https://my.spokanecity.org/about/economy/)
- [Visit Spokane — the economic impact of tourism](https://www.visitspokane.com/industry/industry-resources/)
- [WSU Spokane (health sciences campus, University District)](https://spokane.wsu.edu/)
- [City of Spokane — Kendall Yards project](https://my.spokanecity.org/projects/kendall-yards/)
- [USAFacts — Spokane, WA metro population](https://usafacts.org/answers/how-many-people-live-in-the-us/metro-area/spokane-wa/)

**How big is the Spokane, WA market?** The Spokane-Spokane Valley metro held about 605,000 residents in 2024 and produced roughly $39.7 billion in gross domestic product in 2023. It is the commercial, medical, and retail hub of the Inland Northwest, functioning alongside Coeur d'Alene, Idaho, as part of a shared regional economy and media market.

**What industries anchor the Spokane economy?** Health care leads, with Providence Inland Northwest Washington and MultiCare Health System among Spokane County's largest employers, and WSU Spokane's Elson S. Floyd College of Medicine anchoring the University District. Tourism is a major second pillar — Spokane County saw a record 10.2 million visitors in 2025 — alongside higher education, aerospace and advanced manufacturing, and logistics.

## Taxes for a dental practice in Spokane, WA
A Spokane business owner deals with state and local business taxes and licensing, and Washington's structure is distinctive. The Washington Department of Revenue administers the business and occupation (B&O) tax, a gross-receipts tax measured on the value of products or the gross income of the business, with no deduction for labor, materials, or other costs 7. The same department administers Washington's retail sales tax and the complementary use tax, which are collected on a destination basis — the rate depends on where the customer receives the goods or service 8. Washington has no state personal or corporate income tax, so there is no state income-tax withholding for employers. Most businesses register and report through a single state Business License Application processed by the Department of Revenue's Business Licensing Service 9, which also carries city endorsements 10. In Spokane, the city's business registration is obtained as a City of Spokane endorsement on that state application rather than as a standalone city license 11. Because rates, fees, thresholds, and filing dates change and depend on your operation, confirm your current obligations directly with each authority below.

- [Washington Department of Revenue — business & occupation (B&O) tax](https://dor.wa.gov/taxes-rates/business-occupation-tax)
- [Washington Department of Revenue — retail sales & use tax](https://dor.wa.gov/taxes-rates/retail-sales-tax)
- [Washington Department of Revenue — apply for a business license](https://dor.wa.gov/open-business/apply-business-license)
- [Washington Department of Revenue — city endorsements](https://dor.wa.gov/manage-business/city-endorsements)
- [Washington Department of Revenue — City of Spokane endorsement](https://dor.wa.gov/manage-business/city-endorsements/spokane)
- [City of Spokane — business licenses](https://my.spokanecity.org/business/doing-business/licenses/)

**What business taxes does a Spokane, WA business owner face?** The Washington Department of Revenue administers the business and occupation (B&O) gross-receipts tax and the state retail sales and use tax, both reported to the department. Washington has no state income tax, so there is no state income-tax withholding. City obligations are handled as a City of Spokane endorsement on the state Business License Application. Confirm current rates, fees, and filing dates with the Department of Revenue.

**How does the City of Spokane business license work?** Washington uses a single state Business License Application through the Department of Revenue's Business Licensing Service, and the City of Spokane's registration is added as a city endorsement on that same application rather than as a separate city license. Apply online through the Department of Revenue, and confirm your specific city endorsement requirements with the city.

## How to start a dental practice in Spokane, WA
Beyond the general steps of forming your entity and filing Washington's Business License Application, opening a dental practice in Spokane carries dental-specific requirements — treat each as a link-out and confirm current forms and fees with the office. The dentist must hold an active Washington license issued through the Washington State Department of Health, whose Dental Quality Assurance Commission sets the standards for dentists practicing in the state 1217. Any dental hygienists and dental assistants you employ credential separately through the Department of Health as well 13. A Spokane practice that administers or prescribes controlled substances needs a federal DEA registration through the DEA Diversion Control Division 14. As an employer with clinical staff, your office follows federal OSHA standards, including the Bloodborne Pathogens standard that OSHA enforces in dentistry 15. Dental X-ray equipment used in a Spokane County practice must be registered under Washington's radiation rules administered by the Department of Health 16. Peers at the Spokane District Dental Society and the Washington Small Business Development Center's Spokane Valley office can help you sequence these steps.

- [Washington State Department of Health — Dentist licensing](https://doh.wa.gov/licenses-permits-and-certificates/professions-new-renew-or-update/dentist)
- [Washington State Department of Health — Dental Hygienist licensing](https://doh.wa.gov/licenses-permits-and-certificates/professions-new-renew-or-update/dental-hygienist/licensing-information)
- [DEA Diversion Control Division — practitioner registration](https://www.deadiversion.usdoj.gov/drugreg/registration.html)
- [OSHA — Dentistry enforcement (Bloodborne Pathogens)](https://www.osha.gov/dentistry/enforcement)
- [Washington State Department of Health — X-Ray equipment registration](https://doh.wa.gov/community-and-environment/radiation/x-ray/x-ray-equipment-registration)
- [Washington Dental Commission (DQAC)](https://doh.wa.gov/licenses-permits-and-certificates/professions-new-renew-or-update/dentist/washington-dental-commission)

**Which credentials and registrations does opening a Spokane dental practice involve?** The dentist needs an active Washington license through the Washington State Department of Health and its Dental Quality Assurance Commission; hygienists and assistants credential separately with the department. A practice that handles controlled substances registers with the DEA, follows federal OSHA standards, and registers its dental X-ray equipment under Washington's radiation rules. Confirm current forms and fees with each office.

**Is dental X-ray equipment regulated when I open a practice in Spokane?** Yes. Dental X-ray equipment must be registered under Washington's radiation rules, administered by the Washington State Department of Health's X-ray program. Requirements and fees change, so confirm the current process directly with the department before installing or operating equipment.

## Marketing a dental practice in Spokane, WA
For a Spokane dental practice, most new patients begin online, so marketing starts with local search visibility. BrightLocal's 2024 Local Consumer Review Survey found that 75% of consumers always or regularly read online reviews for local businesses 18, and Google is the platform they use most. A complete, accurate Google Business Profile — hours, address, phone, services, photos — plus steadily gathered patient reviews is the foundation for appearing when Spokane-Spokane Valley residents search for a dentist 20. That matters because roughly 32% of U.S. dentists told the ADA Health Policy Institute in early 2026 they were not busy enough and could treat more patients — open chair hours that local marketing can help fill 19. Layer local reach on top: the Spokane Journal of Business, the Inland Northwest's independent business newspaper 21, and The Spokesman-Review, the region's daily 22, reach patients across downtown Spokane, the University District, Kendall Yards, and the South Perry District. For discovery, list on dental directories such as Healthgrades 23 and seek referrals through the Spokane District Dental Society and the Washington State Dental Association. One caution: dentist advertising in Washington is governed by the Washington Dental Quality Assurance Commission's rules — review them before running comparative or specialty claims. This is general information, not legal advice.

- [Google Business Profile (create/manage your listing)](https://www.google.com/business/)
- [BrightLocal Local Consumer Review Survey 2024](https://www.brightlocal.com/research/local-consumer-review-survey-2024/)
- [Spokane Journal of Business](https://www.spokanejournal.com/aboutus)
- [The Spokesman-Review (Spokane daily)](https://www.spokesman.com/)
- [Healthgrades — general dentistry directory](https://www.healthgrades.com/dentistry-general-directory)
- [Washington Dental Quality Assurance Commission (DQAC) — dentist licensing & regulation](https://doh.wa.gov/licenses-permits-and-certificates/professions-new-renew-or-update/dentist/washington-dental-commission)

**What is the single highest-impact marketing step for a new Spokane dental practice?** Claim and fully complete your Google Business Profile, then steadily gather patient reviews. BrightLocal's 2024 survey found 75% of consumers regularly read online reviews and Google is the top platform, so an accurate, active profile drives local discovery for Spokane-Spokane Valley patients searching for a dentist.

**Are there special rules for advertising a dental practice in Spokane, WA?** Yes. Dentist advertising in Washington is governed by the Washington Dental Quality Assurance Commission under the Washington State Department of Health. Review its rules before running comparative or specialty claims, and confirm current requirements with the commission. This is general information, not legal advice.

## Customer service & reputation for dental practices in Spokane, WA
For Spokane-Spokane Valley dental practices, the platforms that turn searches into booked chair time are Google Business Profile, Zocdoc, and the ADA's Find-a-Dentist directory — and each carries service rules worth knowing. Google lets each public-facing dentist keep an individual profile alongside one profile per office location, but a practitioner should keep only one profile at a single primary location, not one per specialty 24. Zocdoc lets Spokane patients filter by dental insurance and book real-time openings online, with reviews written by patients the provider indicated attended an appointment 25. ADA member dentists can opt into Find-a-Dentist, a directory of more than 100,000 member dentists searchable by ZIP code, specialty, and insurance 26. Two rules bound how you handle reviews. The FTC's Consumer Reviews and Testimonials Rule, effective October 21, 2024, prohibits fake or purchased reviews and undisclosed insider reviews 27. And under HIPAA, a practice replying to a public review may not confirm the person was a patient or reveal any health detail — federal regulators settled with a dental office (New Vision Dental) that disclosed patient information in review responses 28. Route consumer complaints about a Spokane dentist — who may draw patients from the Providence and MultiCare networks across Spokane County — to the Washington Dental Quality Assurance Commission, and the Spokane District Dental Society for referral questions.

- [Google Business Profile — representation guidelines (practitioners)](https://support.google.com/business/answer/3038177)
- [Zocdoc — find dentists by dental insurance](https://www.zocdoc.com/insurances/dental)
- [ADA Find-a-Dentist (member dentist directory)](https://findadentist.ada.org/)
- [FTC — Consumer Reviews and Testimonials Rule (Q&A)](https://www.ftc.gov/business-guidance/resources/consumer-reviews-testimonials-rule-questions-answers)
- [HHS OCR — dental practice settlement over PHI in review responses (New Vision Dental)](https://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/agreements/new-vision-ra-cap/index.html)
- [Washington Dental Commission (DQAC) — consumer complaints](https://doh.wa.gov/licenses-permits-and-certificates/professions-new-renew-or-update/dentist/washington-dental-commission)

**Which review and booking sites matter most for a Spokane dental practice?** Google Business Profile first — claim it and keep hours, location, insurance, and services accurate. Then Zocdoc for real-time booking filtered by dental insurance, and the ADA's Find-a-Dentist directory if you are an ADA member, so Spokane-Spokane Valley searches convert into booked chair time.

**Can our Spokane practice reply to a patient's online review?** Yes, but carefully. Under HIPAA you may not confirm the reviewer was a patient or disclose any health information — HHS OCR settled with a dental office (New Vision Dental) over exactly this — and the FTC's rule bars fake or undisclosed insider reviews. Keep replies generic, invite the person to contact the office privately, and route formal complaints to the Washington Dental Quality Assurance Commission.

## Financing & cash flow for a dental practice in Spokane, WA
A Spokane owner can pursue capital through several channels. The U.S. Small Business Administration's Seattle District Office serves Washington and ten northern Idaho counties, backing 7(a), 504, and microloan programs through partner lenders 29. The Washington Small Business Development Center, hosted by Washington State University, provides no-cost advising from its Spokane Valley network headquarters 30, and SCORE Spokane (Chapter 180, founded in 1973) offers free mentoring — in the past year it helped 34 businesses get started and create more than 140 jobs 31. Washington's Department of Commerce received $163.4 million from the U.S. Treasury's State Small Business Credit Initiative to fund capital-access programs statewide 32. Locally, the Northwest Business Development Association, a Spokane Valley certified development company established in 1982, funded more than 180 SBA 504 loans over two years, creating or retaining more than 1,800 jobs 33. The state's Small Business Flex Fund offers loans up to $150,000 through a network of community lenders including Craft3 34. Two Spokane-based credit unions also lend to small businesses — STCU, through its downtown commercial banking office 35, and Numerica Credit Union, a top SBA lender in the Seattle District offering 7(a) and 504 loans 36.

- [SBA Seattle District Office (Washington and northern Idaho)](https://www.sba.gov/district/seattle)
- [Washington Small Business Development Center (WSU-hosted)](https://wsbdc.org/about-us/)
- [SCORE Spokane (free mentoring)](https://spokane.score.org/about-us-64)
- [Washington Department of Commerce — SSBCI small-business loan programs](https://www.commerce.wa.gov/washington-state-receives-163-4-million-to-fund-innovative-small-business-loan-programs/)
- [Northwest Business Development Association (SBA 504 CDC, Spokane Valley)](https://www.nwbusiness.org/)
- [Small Business Flex Fund (Washington community-lender loans)](https://smallbusinessflexfund.org/)
- [STCU — business banking and lending](https://stcu.org/business)
- [Numerica Credit Union — SBA loans](https://www.numericacu.com/business/sba-loans)

**Where can a Spokane small business find capital and free help?** Start with the SBA Seattle District Office, which backs 7(a), 504, and microloan programs through partner lenders, and the Washington Small Business Development Center and SCORE Spokane for free advising. Local options include the Northwest Business Development Association for SBA 504 real estate and equipment loans, the state's Small Business Flex Fund, and Spokane-based credit unions such as STCU and Numerica.

**Are there Washington state programs that help Spokane businesses borrow?** Yes. The Washington State Department of Commerce received $163.4 million from the U.S. Treasury's State Small Business Credit Initiative to fund capital-access programs, and the public-private Small Business Flex Fund offers loans through community lenders including Craft3. Terms and eligibility change, so confirm current details with each program directly.

## Finding & keeping dental practice staff in Spokane, WA
Spokane dental practices hire hygienists and assistants into a competitive market, and local training pipelines are the advantage. Nationally, the U.S. Bureau of Labor Statistics projects dental hygienist employment to grow 7% from 2024 to 2034, with a median annual wage of $94,260 in May 2024 37, and dental assistant employment to grow about 6%, with a median wage of $47,300 38. Hiring is tight: in ADA Health Policy Institute polling, roughly one-third of dentists reported recruiting a hygienist, and about nine in ten of those called it very or extremely challenging 39. Spokane's edge is local supply. Eastern Washington University runs a long-standing Bachelor of Science dental hygiene program from its Spokane health-sciences campus, and Spokane Community College trains chairside staff through its CODA-accredited dental assisting program — both feeding graduates into Inland Northwest practices. Credential your hires through the Washington State Department of Health's Dental Quality Assurance Commission, and direct wage-and-hour questions to the Washington Department of Labor & Industries rather than relying on general guidance.

- [BLS Occupational Outlook Handbook: Dental Hygienists](https://www.bls.gov/ooh/healthcare/dental-hygienists.htm)
- [BLS Occupational Outlook Handbook: Dental Assistants](https://www.bls.gov/ooh/healthcare/dental-assistants.htm)
- [Eastern Washington University — Dental Hygiene (BS), Spokane](https://www.ewu.edu/chsph/dental-hygiene/)
- [Spokane Community College — Dental Assisting program](https://scc.spokane.edu/What-to-Study/Degree-Description?id=266)
- [Washington Dental Commission (DQAC) — dental credentialing](https://doh.wa.gov/licenses-permits-and-certificates/professions-new-renew-or-update/dentist/washington-dental-commission)

**How hard is it to hire hygienists and assistants in Spokane?** Expect competition. In ADA Health Policy Institute polling, about a third of dentists were recruiting a hygienist and roughly nine in ten of them called it very or extremely challenging; nationally BLS projects hygienist employment to grow 7% through 2034. Spokane's advantage is local supply from Eastern Washington University's dental hygiene program and Spokane Community College's dental assisting program.

**Where do Spokane dental practices find trained hygienists and assistants?** Eastern Washington University trains dental hygienists at its Spokane health-sciences campus, and Spokane Community College runs a CODA-accredited dental assisting program. Credential your hires through the Washington State Department of Health's Dental Quality Assurance Commission, and take wage-and-hour questions to the Washington Department of Labor & Industries.

## Giving back in Spokane, WA
Spokane's small-business community supports a dense network of local nonprofits. Second Harvest Inland Northwest has led regional hunger relief since 1971, moving food through a network of more than 250 partner food banks and meal centers across eastern Washington and north Idaho 40. The Spokane-based Innovia Foundation, the region's community foundation since 1974, serves a 20-county area and six Native American Tribes and has awarded more than $105 million in grants and scholarships 41. Spokane Neighborhood Action Partners (SNAP), founded in 1966, is the area's anti-poverty agency, delivering energy assistance, rental and homeless services, and homebuyer education 42. The Vanessa Behan Crisis Nursery, founded in 1987, provides 24-hour emergency refuge for young children and support for families in crisis 43. Businesses that donate surplus food are shielded from civil and criminal liability for good-faith donations under the federal Bill Emerson Good Samaritan Food Donation Act 44. Confirm current donation and volunteer needs with each organization directly.

- [Second Harvest Inland Northwest (regional food bank)](https://2-harvest.org/)
- [Innovia Foundation (Inland Northwest community foundation)](https://innovia.org/spokane/)
- [Spokane Neighborhood Action Partners (SNAP)](https://www.snapwa.org/about-us-2/)
- [Vanessa Behan Crisis Nursery](https://www.vanessabehan.org/news/vanessas-story/)
- [USDA — Bill Emerson Good Samaritan Act food-donation liability protection](https://www.usda.gov/about-usda/news/blog/good-samaritan-act-provides-liability-protection-food-donations)

**Which Spokane nonprofits can a small business support?** Second Harvest Inland Northwest anchors regional hunger relief and works with more than 250 partner food banks and meal centers. Other established Spokane organizations include the Innovia Foundation (the region's community foundation), Spokane Neighborhood Action Partners (SNAP) for anti-poverty and housing services, and the Vanessa Behan Crisis Nursery for young children and families in crisis.

**Is a Spokane restaurant protected if it donates leftover food?** Yes. The federal Bill Emerson Good Samaritan Food Donation Act protects businesses, nonprofits, and individuals from civil and criminal liability when they donate apparently wholesome food in good faith, limiting liability to gross negligence or intentional misconduct. Local food banks such as Second Harvest can advise on safe handling and accepted items.

## When things are slow: a cushion for your dental practice in Spokane, WA
For a Spokane dental practice, excess capacity shows up as open chair hours and unfilled hygiene slots — time that earns nothing once it passes. Spokane's calendar makes this concrete: summer is the region's peak visitor season, drawing crowds to downtown events like Hoopfest, while winter is the slowest stretch 46 — and patients travel and reschedule around the holidays and the deep Inland Northwest winter, leaving predictable schedule holes. No-shows widen them: an analysis of more than 1.6 million dental appointments across 64 practices found missed visits fell by nearly 23% only after automated reminders were adopted, evidence of how routinely chairs sit empty 45. ITEX cashless trade lets your practice put that open or off-peak time to work with ITEX-network patients who pay in trade dollars instead of cash. You bill your normal fees, earn ITEX dollars on otherwise-empty hours, then spend them on real costs — dental lab work, marketing, equipment servicing, staff appreciation — which conserves cash. It works year-round as an incremental demand generator that also cushions slower stretches. The local office is ITEX Spokane North 47; ask the broker how to list your open capacity to the trade network.

- [ADA Health Policy Institute — State of the U.S. Dental Economy (Q1 2026)](https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/state_us_dental_economy_q12026.pdf)
- [Dental Tribune: automated reminders and dental no-show rates](https://us.dental-tribune.com/news/study-reveals-how-automated-patient-appointment-reminders-affect-dental-practice-no-show-rates-and-production/)
- [Visit Spokane — seasonal things to do (summer peak)](https://www.visitspokane.com/things-to-do/seasonal/summer/)
- [ITEX Spokane North (local broker office)](http://spokane-north.itex.com/)
- [Join ITEX](https://spokane-north.itex.com/GetStarted.aspx?ref=grow&v=dental&g=spokane-wa)

**When are the slow stretches for a Spokane dental practice?** Schedule holes tend to cluster around summer travel — Spokane's peak visitor season, with events like Hoopfest — the holidays, and the deep Inland Northwest winter, on top of everyday cancellations and no-shows. ITEX helps route network patients into that open time so you monetize hours that would otherwise pass unused.

**Do I have to discount my fees to attract ITEX patients during slow periods?** No. You bill your standard fees in ITEX trade dollars, protecting your fee schedule while monetizing chair time that would otherwise go empty. The ITEX Spokane North broker can help match your slower days and off-peak hours with network patients seeking care.

## Resources to scale & grow your dental practice in Spokane, WA
For a Spokane, WA dental practice, empty chair hours and unfilled hygiene slots are the capacity to fill — cheapest and highest-intent channels first. Start by listing with ITEX: the local ITEX Spokane North office connects your practice to the largest marketplace for business-to-business cashless trade in the US and Canada, turning open slots into trade dollars 47. Then claim the free listings that put you on the map — a Google Business Profile for Google Search and Maps 20, an Apple Business Connect place card for Apple Maps 48, and a Bing Places for Business listing 49 — and ask every satisfied patient for a review. For local standing, join Greater Spokane Incorporated, the region's chamber and economic-development organization 50, and tap the Washington State Dental Association 51 and the Spokane District Dental Society 52 for referrals, networking, and patient discovery. Layer in Spokane-geotargeted paid search, recall email and SMS reminders, coverage in the Spokane Journal of Business, and a presence at community events like free screening days and Hoopfest.

- [List with ITEX Spokane North](http://spokane-north.itex.com/)
- [Google Business Profile](https://www.google.com/business/)
- [Apple Business Connect](https://www.apple.com/newsroom/2023/01/introducing-apple-business-connect/)
- [Bing Places for Business](https://www.bing.com/forbusiness)
- [Greater Spokane Incorporated (chamber / economic development)](https://greaterspokane.org/member-benefits/)
- [Washington State Dental Association](https://www.wsda.org/)
- [Spokane District Dental Society](https://www.spokanedentalsociety.org/)

**What is the fastest way to fill empty chair hours at a Spokane dental practice?** List with ITEX. The local ITEX Spokane North office connects you to the largest B2B cashless trade network in the US and Canada, so open slots convert into trade dollars you can spend on practice needs instead of going unused. Pair it with a claimed Google Business Profile and Apple Maps listing so new patients can also find and book those open times.

**How do new patients in Spokane usually find a dentist?** Most start with an online search, so the highest-leverage channels are free listings — Google Business Profile, Apple Business Connect, and Bing Places — plus actively gathered reviews. Reinforce with local networking through Greater Spokane Incorporated, the Washington State Dental Association, and the Spokane District Dental Society, and Spokane-geotargeted paid search.

## About ITEX
ITEX is one of the longest-running barter communities in North America, with over 30 locations and thousands of member businesses across North America.

## References
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2. Federal Reserve Bank of St. Louis (FRED), U.S. Bureau of Economic Analysis data. Total Gross Domestic Product for Spokane-Spokane Valley, WA (MSA) (DISCONTINUED) (NGMP44060). https://fred.stlouisfed.org/series/NGMP44060 (accessed 2026-08-08)
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18. BrightLocal. Local Consumer Review Survey 2024. https://www.brightlocal.com/research/local-consumer-review-survey-2024/ (accessed 2026-08-08)
19. ADA Health Policy Institute. The State of the U.S. Dental Economy, 1st Quarter 2026 Update. https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/state_us_dental_economy_q12026.pdf (accessed 2026-08-08)
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