Inside Sage Dental's Southeastern expansion blueprint

Boca Raton, Fla.-based Sage Dental has started to widen its reach, recently announcing plans to open its first practices in Tennessee, driven by a regional expansion strategy.

The DSO expects to open four Sage Dental practice locations in Tennessee in June and July, marking its presence in a third state.

The company is one of the larger DSOs in the Southeastern U.S., currently supporting more than 120 practices in Florida and Georgia.

Jim Mizouni, Sage's chief development officer, connected with Becker's to explain why Tennessee was chosen for the company's first expansion outside of Florida and Georgia, as well as future plans for growth.

Note: Responses were lightly edited for clarity and length.

Question: What led to the decision to open practices in Tennessee after building up a network across Florida and Georgia?

Jim Mizouni: The decision to move into Tennessee was driven by Sage Dental's adjacency growth strategy. Being a Florida-based DSO has been particularly advantageous for our organization, especially given the significant population growth in Florida over the last years. Sage is dedicated to remaining strategic with our growth plans, preferring to expand to the next local contiguous market after careful consideration, rather than just scattering our efforts across the country. This approach is driven by our core clinical program, which provides all dental services under one roof and requires a dense network of practices. This model allows for the presence of various specialists, such as orthodontists, endodontists, periodontists and oral surgeons, within a close geographic area to optimize both operational efficiency and marketing efforts.

The proximity of Tennessee to our existing base in Florida and Georgia made it an optimal choice for our next phase of growth. This regional expansion ensures a tight adjacency of practices, facilitating operational support and enhancing the overall efficiency and effectiveness of our clinical services.

Q: Why was Tennessee an attractive state for expansion over other states in the Southeast?

JM: We saw several positive dynamics within Tennessee that ultimately fueled our expansion decision. Firstly, population trends and moving data indicate that the Carolinas and Tennessee are becoming increasingly attractive regions. While Florida has traditionally remained a popular region, rising costs and affordability factors have led to an increased desire among many to move away from northern states, but not as far south as Florida, making Tennessee an appealing middle ground.

Additionally, Tennessee's lack of state income tax is highly appealing to newcomers. These factors, combined with the significant migration into the Tennessee and Carolina areas, create a favorable environment for Sage's expansion. We believe these dynamics align well with our brand goals and will continue to support our journey of strategic growth. 

Q: Are there currently any plans to expand into any other new states or regions?

JM: This is an area where we want to be disciplined. Our goal isn't to open within 10 new markets at the same time and stretch ourselves too thin. Tennessee alone offers multiple attractive markets such as Nashville, Knoxville, Memphis and Chattanooga, which fits between our current Atlanta base and Nashville. In the Carolinas, we are exploring several future markets, starting with Charleston and expanding into Greenville and Spartanburg.

Additionally, we plan to expand into Alabama, focusing on the northern region, including Birmingham and Huntsville. Huntsville, although not high on everyone's radar, has a lot of unique attributes, including growth in the space industry and engineering sectors.

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