Close · Dental Practice Management

Mezzanine Debt & Capital Stack Counsel for Dental Practice Management Acquisitions

Securities and M&A counsel for independent sponsors structuring dental practice management transactions, from LOI to close to the capital markets that open up afterward.

EV range $10M to $130M EV EBITDA $2.5M to $22M Audience Independent Sponsor
The deal context

Dental Practice Management deals in the lower middle market run a specific playbook. Mezzanine Debt & Capital Stack is where the structure either holds or starts to leak.

The typical dental practice management platform sits at $10M to $130M EV with EBITDA in the $2.5M to $22M range. The thesis runs on DSO buy-up under an MSO. Insurance mix dictates valuation. Read the PPO contracts before the EBITDA.

The moves

How Mezzanine Debt & Capital Stack actually gets structured.

  1. Target senior leverage at 3.0x to 3.5x EBITDA, mezzanine at 1.0x to 1.5x on top.

  2. Negotiate an intercreditor agreement that does not throttle the operator.

  3. Structure mezzanine with PIK toggle and warrants priced into the IRR model.

  4. Confirm covenant headroom of at least 20 percent at close.

  5. In dental practice management, layer in MSO model documented per state as part of the Mezzanine Debt & Capital Stack workstream.

The common mistake

Letting the lender pick the intercreditor terms. Those terms decide what the operator can do on day 180.

Jason's take
"The capital stack is a contract, not a spreadsheet. Read every page of every term sheet."
Jason Powell · Mezzanine Debt & Capital Stack
Capital after close

The deal is one thing. The capital that opens up after close is another.

After close, the call list for refinancing, recapitalization, and growth equity gets short and known. Jason carries that list.

MONTH 18
Senior refi
MONTH 24
Dividend recap
MONTH 36
Growth equity
YEAR 4–5
Strategic exit
ENGAGE THE PRACTICE

Mezzanine Debt & Capital Stack for Dental Practice Management, on independent sponsor terms.

Independent sponsor counsel that already speaks fluent deal-by-deal economics, structures clean LPAs, and travels with capital markets relationships for what comes after close.