Dental Office Lease Attorney | Cohen Law Firm

A dental office lease is the single largest fixed cost most dentists ever sign — and the single legal document most likely to constrain how, when, and to whom you can sell your practice. Cohen Law Firm, PLLC has reviewed, negotiated, and litigated dental office leases as part of more than 300 dental practice transactions every year. We represent dentists across the United States from offices in Dallas, TX and Kirkland (Seattle Metro), WA.

This page covers everything a practice owner needs to know about commercial leases for dental practices — what makes a dental office lease different, the eight lease provisions that decide whether you can sell or relocate, how to evaluate working with a dental real estate broker, and the state-specific considerations that apply in Texas and Washington.

Published: May 24, 2026  ·  Reviewed by: David Cohen, Managing Attorney

Cohen Law Firm provides dedicated dental office lease attorney services to dentists who are leasing new space, renewing existing leases, subleasing, assigning a lease as part of a practice sale, or buying the building their practice occupies. As a firm that focuses exclusively on the legal needs of dentists and dental specialists, we understand how a dental practice’s operational requirements — water lines, plumbing for chairs, lead-shielded x-ray walls, HVAC for sterilization equipment, ADA-compliant treatment rooms — translate into specific lease clauses that general commercial real estate lawyers routinely miss.

Our dental real estate practice covers:

• Dental office lease review and negotiation — from letter of intent through executed lease, including base rent escalation, CAM charges, percentage rent, exclusivity clauses, and use restrictions
• Dental office lease renewal — identifying renewal traps, negotiating fair market rent reset clauses, and protecting tenant improvement amortization
• Dental office lease assignment when buying or selling a practice — coordinating landlord consent, releasing the seller from continuing liability, and protecting the buyer’s right to renew
• Dental office sublease arrangements — for orthodontists subletting from general dentists, specialists sharing space, or owners scaling down before retirement
• Commercial purchase of dental office buildings — when leasing no longer fits the long-term plan and ownership becomes the better option
• Tenant improvement (TI) negotiation — drafting work letters that protect the dentist from cost overruns and ensure landlord-completed work meets dental-grade specifications
• Build-out lease structures — coordinating the lease, construction contract, and equipment financing for new dental practice startups
• Lease disputes and litigation — when landlords overreach on CAM reconciliations, fail to maintain the premises, or improperly withhold consent to assignment

If you’re early in the process, we recommend reading our guides on legal considerations every dentist should know before signing a lease and top tips for tenants in dental office lease negotiations.

Most landlords and brokers treat a dental practice like any other professional services tenant. That assumption costs dentists money on every deal. Five operational realities make dental office leases categorically different:

1. Build-out cost asymmetry. A dental practice tenant typically invests $150,000–$500,000 in tenant improvements to make a vanilla shell or general office space operational — plumbing, electrical for chairs, compressor and vacuum lines, lead-lined x-ray walls, dedicated HVAC. That investment vanishes if the lease ends or the landlord refuses renewal on reasonable terms. The lease has to amortize this investment correctly.
2. Practice value is tied to the location. Unlike most service businesses, a dental practice cannot easily relocate. Patient lists, referral patterns, and demographic geography are tied to the specific address. A landlord who knows this has enormous leverage at renewal time — a leverage your lease should constrain.
3. Practice sale depends on lease assignment. When you sell your practice in 10–20 years, the buyer will require a long-term lease at a known cost. If your current lease has only two years left and no extension option, your sale price will drop by 10–25%. The lease you sign today becomes a critical asset in the sale you haven’t planned yet.
4. Exclusivity and use restrictions matter more. A general office tenant doesn’t care if a competitor moves in next door. A dental practice does. The “permitted use” and “exclusivity” clauses determine whether another dentist, an orthodontist, or a DSO-owned practice can open in the same building or shopping center.
5. Regulatory overlay. Dental offices face state board inspections, OSHA dental-specific rules, HIPAA workspace requirements, and ADA accessibility obligations. The lease must permit signage, accommodations, and modifications that compliance often requires after the lease is signed.

Out of every dental office lease we’ve reviewed, these eight provisions account for the vast majority of disputes and lost value:

1. Use Clause and Exclusivity — The “use clause” defines what your practice is permitted to do at the premises. A narrow use clause (“general dentistry only”) prevents you from adding orthodontics, oral surgery, or sleep dentistry later. An “exclusivity clause” prevents the landlord from leasing other space to a competing dental practice. Both should be negotiated explicitly.

2. Tenant Improvement (TI) Allowance and Work Letter — The TI allowance is the landlord’s contribution to your build-out. A typical dental practice build-out cost is $150–$300 per square foot; landlord TI allowances range from $30–$80 per square foot depending on the market and lease term.

3. Assignment and Subletting — This clause determines whether you can sell your practice. Most standard commercial leases give the landlord absolute discretion to approve or reject an assignment. That gives the landlord effective veto power over your eventual practice sale. We negotiate “reasonable consent” language with specific objective criteria the landlord must apply.

4. Renewal Options and Rent Reset Mechanism — Lease renewal options must specify (a) how many extension terms are available, (b) the notice required to exercise, and (c) how rent is reset. “Fair market rent” sounds reasonable but is notoriously easy for landlords to manipulate.

5. CAM (Common Area Maintenance) Charges and Reconciliation — CAM charges are the most-litigated category in commercial real estate. Capping CAM escalation at 3–5% per year and excluding capital expenses, management fees over a market rate, and landlord administrative costs are basic protections that landlords often resist.

6. Permitted Alterations and Compliance Obligations — Dental practices change equipment regularly. The lease must permit alterations under reasonable terms, including a landlord’s obligation to consent within a specific timeline. ADA compliance work, OSHA-required modifications, and HIPAA workspace requirements should be addressed.

7. Casualty, Condemnation, and Business Interruption — What happens if a fire damages the office? If a tornado destroys the building? Dental practices cannot pause patient care; the lease must address rent abatement, restoration timelines, and termination rights with the dental practice’s continuity needs in mind.

8. Personal Guaranty and Cap on Liability — Landlords typically require personal guarantees from new dental practice tenants. We negotiate guaranty caps (limiting personal liability to 12–24 months of rent), burn-off provisions (the guaranty terminates after 36 months of timely payment), and clear release on assignment to a qualified buyer.

For a deeper walk-through of each of these clauses from the landlord’s side, see our guide on key lease considerations for landlords in the dental industry.

Dentists evaluating real estate consistently face the same decision: lease the practice space, or buy the building. Both approaches work for the right practice; the decision turns on factors specific to your situation.

Leasing is usually better when:

• You’re in the first 1–5 years of practice and capital is limited
• You expect to relocate or expand to multiple locations within 5–10 years
• The local commercial real estate market is overheated relative to long-term fundamentals
• You don’t want the responsibility of managing other tenants in a multi-tenant building
• The available buildings in your target geography don’t fit your practice’s growth plan

Buying is usually better when:

• You’ve been in practice 5+ years with stable revenue and predictable patient flow
• You intend to practice in the same location for the next 10+ years
• You’re approaching practice transition and want to control the real estate as a separate asset
• SBA 504 financing is available at favorable rates (typical SBA-eligible dental building loans run 20–25 years with 10% down)
• The building gives you tax advantages (depreciation, mortgage interest deduction, eventual capital appreciation)

Cohen Law Firm structures both transaction types. If you’re considering ownership, we coordinate the purchase, the SBA financing, the title work, and (in most cases) the formation of a separate real estate holding entity that owns the building and leases back to the dental practice. If you’re also considering whether buying or selling a practice is the right next step, see our practice acquisition services or our dental practice sales services.

A dental real estate broker represents the buyer or tenant in commercial real estate transactions specifically involving dental practices. A dental practice brokerage is a broader category that includes brokers who handle the sale of operating dental practices (the business and goodwill), often including the related real estate when the practice owns its building.

Cohen Law Firm works alongside dental real estate brokers and practice brokerage firms on dozens of transactions every year. The broker’s job is to find the right space or building; our job is to structure the legal terms. Together, the broker’s market knowledge and our legal protection deliver the best outcome.

When evaluating a dental real estate broker, look for:

• Dental-specific experience. Has the broker closed 10+ dental office lease or purchase transactions? General commercial brokers miss the practice-specific issues.
• Tenant or buyer representation, not dual agency. A broker representing both you and the landlord cannot fully advocate for either side.
• Transparent commission structure. Tenant-rep commissions are paid by the landlord but show up in your rent. Understanding who pays what reveals whose interests the broker actually serves.
• Coordination with your attorney and CPA. The best brokers expect to work with your dental attorney from the LOI stage forward.

For more, see why dentists need a commercial real estate attorney and when a real estate joint venture structure makes sense.

Cohen Law Firm’s Dallas office at 13355 Noel Rd, Suite 1100, Dallas, TX 75240 serves dental practices throughout Texas. Texas dental real estate transactions have several state-specific dimensions:

• Texas commercial leases are heavily landlord-favorable by default. Texas does not impose many implied warranties on commercial landlords; what’s negotiated into the written lease is what you get. This makes attorney-led lease negotiation more important in Texas than in many other states.
• Property tax structure. Texas has no state income tax but high commercial property taxes. CAM provisions in Texas dental leases must address property tax pass-through carefully.
• Texas State Board of Dental Examiners (TSBDE) compliance. The lease premises must permit the operational changes that TSBDE compliance occasionally requires.
• SBA 504 financing for dental practice buildings. Texas dental practice purchases are well-served by SBA 504 loans through Texas-based CDCs.
• DFW metro market dynamics. Dallas-Fort Worth dental real estate is one of the most competitive markets in the country, with both DSO consolidation and a steady flow of new dentists entering the market.

Need a dental attorney in Dallas? Visit our Dallas office page or schedule a Dallas dental office lease consultation.

Cohen Law Firm’s Pacific Northwest office at 635 Market Street, Kirkland, WA 98033 serves dental practices throughout Washington State and the broader Pacific Northwest. Washington dental real estate has its own particulars:

• Washington’s dental corporation rules (RCW 18.32). Washington restricts who may own a dental practice. Real estate ownership structures must avoid inadvertently violating corporate practice of dentistry restrictions — especially when a DSO is involved in the transaction.
• Seattle/Eastside market dynamics. Kirkland, Bellevue, Redmond, and Seattle proper are among the most expensive dental real estate markets in the western United States. Lease rates in prime medical/dental buildings can exceed $50/sq ft NNN.
• Washington commercial leasing law. Washington imposes a duty of good faith and fair dealing more rigorously than Texas, providing somewhat more tenant protection in disputes — but standard form leases still need substantial negotiation.
• Seismic and earthquake provisions. Pacific Northwest dental leases should specifically address seismic upgrade responsibility, business interruption from earthquakes, and equipment replacement timelines after a seismic event.
• Washington State Department of Health (DOH) dental compliance. Lease provisions must permit the modifications and inspections DOH compliance may require.

Need a dental attorney in Washington? Visit our Seattle Metro / Kirkland office page or schedule a Washington dental office lease consultation.

Across the dental office leases Cohen Law Firm reviews each year, the same pitfalls show up repeatedly:

• “Net effective rent” misleading the dentist. Landlords often quote a low base rent plus aggressive CAM, percentage rent, and operating expense pass-throughs that double the true cost.
• Short renewal options. A 5-year initial term with only one 5-year extension leaves the dentist with 10 years of certainty — too short for a practice you expect to sell after year 15.
• “Demolition clause.” Some leases allow the landlord to terminate on 6–12 months notice if the building is sold or redeveloped. Combined with a dental practice’s six-figure build-out, this is a catastrophe waiting to happen.
• Personal guaranty without burn-off. The dentist signs a personal guaranty that survives the entire lease term, even after the practice is sold to a qualified buyer with stronger financials.
• Landlord-favorable assignment language. “Landlord may withhold consent in its sole discretion” effectively veto-proofs your eventual practice sale.
• CAM caps with carve-outs. Some leases cap CAM increases — but exclude property taxes, insurance, and “capital expenses,” which often represent the largest portion of the increase.
• “As-is” delivery without inspection rights. Accepting space “as-is” without a pre-occupancy inspection period transfers all latent defect risk to the dentist.
• Exclusivity tied to specific tenant only. An exclusivity clause that says “no other dentist tenant” sounds great — but doesn’t prevent the landlord from selling the building to a DSO that opens a competing practice.

For practical negotiation tactics, see how a dental attorney can help manage lease agreements for your practice.

Cohen Law Firm is a dental-focused law firm — dental real estate is not a sideline. The firm completes more than 300 dental practice transactions every year, the majority involving the practice’s commercial lease or owned real estate as a core component. That volume produces three concrete advantages for dentist clients:

1. We see every landlord trick. When a national landlord chain inserts an unfavorable clause, we’ve seen it 50 times across other deals. We know which provisions are negotiable and which are landlord red lines.
2. We have benchmark data. What’s a market TI allowance in north Dallas? What CAM cap is reasonable in Kirkland? What’s a fair renewal rent reset in Houston medical office? We know — because we’ve closed deals across all of these markets in the last 12 months.
3. We coordinate the whole transaction. The lease is one piece. Cohen Law Firm also handles practice formation, partnership agreements, associate contracts, DSO transactions, and practice sales — so we structure your real estate to fit the longer-term plan, not in isolation.

The firm operates on flat-fee billing for most lease and real estate matters, with transparent pricing communicated before engagement. Initial consultations are complimentary. Learn more about Cohen Law Firm or meet the attorneys handling your matter.

How much does a dental office lease review cost?

At Cohen Law Firm, a standard dental office lease review and negotiation engagement is typically handled on a flat fee in the $2,500–$5,000 range, depending on the lease length, complexity, and whether the engagement covers initial LOI through executed lease or only review of an already-negotiated draft. Build-out lease reviews involving substantial tenant improvements typically run $4,000–$7,500.

Should I buy or lease my dental office space?

Leasing is usually better in the first 1–5 years of practice or when relocation is possible. Buying becomes the better option after 5+ years of stable practice revenue, when you plan to remain at the location for 10+ years, and especially when transitioning toward eventual practice sale — owning the building separately preserves it as an appreciating asset you can retain after selling the practice.

What’s the most important clause in a dental office lease?

The assignment-and-subletting clause is the single most important provision in a dental office lease — because it determines whether you can sell your practice. A “sole discretion” landlord-consent provision effectively gives the landlord veto power over your eventual practice sale. Always negotiate “reasonable consent” with objective criteria the landlord must apply.

What is a CAM charge in a dental office lease?

CAM (Common Area Maintenance) charges are landlord operating expenses passed through to tenants as additional rent — covering maintenance of shared areas, property taxes, insurance, landlord management fees, and sometimes capital expenses. CAM is the most-litigated category in commercial real estate. Caps on annual escalation (typically 3–5%) and exclusions for capital and administrative expenses are standard tenant protections.

Do I need a dental-specific attorney for my lease?

A general commercial real estate lawyer can handle the basic lease mechanics, but typically misses dental-specific issues — exclusivity tied to dental practice types, TI work letters that meet dental-grade specifications, regulatory compliance language for state dental board inspections, and assignment provisions that protect future practice sale.

How long should my initial dental office lease term be?

Initial terms of 5–10 years with multiple 5-year extension options are standard. A new practice starting from scratch typically wants longer extension protection (3+ renewal options) to support the value of the build-out investment.

What happens to my lease when I sell my dental practice?

When you sell your practice, the lease must be assigned to the buyer (or, less commonly, the buyer signs a new lease with the landlord). The seller’s continuing liability under a personal guaranty must be released as part of the transaction. The buyer will require a long-term lease at known cost as a condition of the practice purchase.

Can I sublease part of my dental office to another dentist or specialist?

Most commercial leases prohibit subleasing without landlord consent. Subleasing arrangements between a general dentist and an orthodontist or specialist are common and workable — but they require explicit lease provisions to avoid creating an unauthorized “use” that gives the landlord grounds for termination.

What’s the difference between a dental real estate broker and a dental practice brokerage?

A dental real estate broker handles the property itself — the commercial lease or building purchase. A dental practice brokerage handles the sale of operating practices (the business, the patient list, the goodwill), and often handles the related real estate when the practice owns its building.

Whether you’re signing your first dental office lease, renegotiating at renewal, evaluating a sublease, or considering buying the building you currently lease — Cohen Law Firm provides experienced, dental-focused legal counsel from Texas, Washington, and to dentists nationwide.

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Or call us directly:
Dallas, TX: 972-695-9359
Kirkland, WA (Seattle Metro): 972-695-9359