For owners ready to grow, sell, or buy.

Find the gaps. Build the value.

Operating infrastructure for orthodontic and dental practices.
We find the operational gaps holding value the practice is not earning today. Then we build the systems, develop your team to run them, and stay until they hold. Lean Six Sigma, at any size.
I'm growing faster than my processes I'm getting sale-ready, or evaluating a buy
Brand story

Something's off, and no one owns it yet.

Every founder-built practice hits the same ceiling eventually: the systems that got it here can't carry it further, and no one's tracking what that costs.

We build what carries it further, systems for an owner scaling past what built the practice, a clean read for one heading toward a sale or sizing up a buy. Either way, it holds without us in the room.

Find the gaps. Build the value.

What the brand promises
  • We think like operators who read the P&L. Every answer names what to do next, and what it's worth.
  • Built for your team to run. Systems simple enough to stick, built to hold without us in the room.
  • Evidence first. Every claim ties back to data or a gap we found.
  • Dental and ortho depth. Ortho is where we go deepest, dental is where we've built the range.
Where to start

Are you running the practice, or preparing for a transaction?

Operations

I'm growing faster than my processes

Same-store growth, expansion, a new ortho specialty that hasn't taken off, or a practice that has outgrown the systems it runs on.

See operations services
Transactions

I'm getting sale-ready, or evaluating a buy

Getting ready or thinking about selling, or evaluating a practice or platform before you buy it.

See transaction services
Operations

The systems didn't keep up, so the workarounds did.

We diagnose before we measure, and measure before we redesign. The Operational Diagnostic and Gap Assessment finds what's off, then points to the right fix, Operating Systems and Workflow Design or Performance Visibility and Accountability Infrastructure. Where the gap is already clear, we scope the fix directly.

Built for solo practices through 50 locations.

Everything runs through you, and you're trying to grow past it
Build the systems
Growing faster than operations can handle
Build the systems
We added ortho, and it isn't producing like it should
Find the gaps
We cannot see or act on our numbers
See and act on the numbers

Operational Diagnostic and Gap Assessment

Find the gaps

A current-state process map, an operational gap inventory scored by impact, a baseline KPI snapshot from your practice management system, and a findings summary with the top three fixes ranked, each tied to a dollar or metric. Delivered over a discovery call, a PMS data pull, on-site observation, and a readout.

Starting at $7,400*
Fifty percent of the diagnostic fee, capped at $7,500, credits toward a fixed-fee build signed within three months. Travel billed separately at cost.

Operating Systems and Workflow Design

Build the systems

Fixes what the diagnostic finds: everything running through the owner, or broken processes and workarounds quietly costing money. Redesigned patient flow, scheduling templates built to your practice model, written clinical-to-admin handoff protocols, a revenue cycle workflow with defined ownership, a recall and reactivation system, and a role and accountability map.

Priced after the diagnostic scopes the build, de novo or legacy rebuild. Rollout oversight is recommended, not required, and priced separately.
Standardizing across multiple locations →

Performance Visibility and Accountability Infrastructure

See and act on the numbers

One dashboard, a defined KPI set by role and location, an operating cadence for who reviews what and how often, and threshold and escalation rules, so the numbers get acted on instead of read once and filed.

Priced to scope, including a cadence retainer once the build is live.
Transactions

Will the operations hold up under a buyer's diligence?

Whether you are preparing to sell or deciding whether to buy, the question is the same: can the operations carry what happens next.

Getting ready to sell, or thinking about it
Get sale-ready
Buying a practice or platform
Know what you are buying

Value Gap Snapshot

Spot the value risks

For an owner 16 months to 3 years from a sale. Surfaces the operational issues most likely to cost you at the negotiating table, before you commit to Transition Readiness. A PMS data pull and analysis, plus a short discovery and readout call. No on-site observation.

Starting at $3,900*
Fully credits toward Transition Readiness if you sign within 45 days.

Transition Readiness

Get sale-ready

For an owner 16 months to 3 years from a sale, recap, or capital partner conversation. An initial roadmap build translates your numbers into a value-readiness plan and reviews them against what a buyer will pay for, with recommended fixes. Quarterly check-ins track progress through the runway to market.

Starting at $9,250*Quarterly check-ins priced separately.
Getting sale-ready, in full →

Operational Due Diligence

Know what you are buying

For anyone evaluating an acquisition: an individual, a group, an emerging DSO, an investor, or a PE deal team. An operational review of the target, a gap and risk inventory, and a read on whether operations can carry the thesis. Scoped to the deal timeline.

Priced by target size and complexity. Ask for a quote.
How operational due diligence works →
Why GME

Every side of a dental transaction.

Gretchen started on the operations side, building dental and orthodontic practices. She moved to the sell-side and spent four years as a broker bringing practices to market, many of them practices she had helped build. Through those years and after, she kept building: operational support inside an operating platform, and the model behind a franchise-like orthodontic concept. Since 2025 she has run operational due diligence and closing support for buy-side clients of an investment banking firm.

Built it. → Sold it. → Designed the alternative to selling it. → Evaluated it for a buyer.
30 years

Building professional service businesses. Fifteen in dental and orthodontics, fifteen prior in accounting firms, law firms, and hospitality. Skilled people are the product in every one of them, and the business outgrows the founder before anyone builds the operating layer underneath it.

320  /  650

Practices and locations reached in total. Of that, 120-plus practices across 350-plus offices were led directly. The rest is strategy advised and infrastructure built.

$158M

In transactions guided and practices prepared for transaction, pre-LOI through close. Counted across the brokerage years and the diligence work.

30 / 14 / 18

Practices, states, and months: the platform Gretchen built the operating model for and scaled, past $25M in net production.

How we work

We run Lean Six Sigma DMAIC on orthodontic and dental operations, the same discipline hospitals use to remove delay and error. Define what is off, measure the current process, isolate what creates rework, redesign around what matters, document it. Every recommendation traces back to something we found in your numbers.

From there we build the systems, develop your team to run them, and stay until they hold, whether you are scaling past what built the practice or getting the operations ready for a buyer's diligence.

How Lean Six Sigma applies to a dental practice →
Gretchen M. Estapa
About

Gretchen M. Estapa

Founder & Managing Principal

Gretchen designs and implements the operating infrastructure orthodontic and dental practices need to grow or get ready for what's next, and stays hands-on through implementation until the systems hold on their own. Thirty years building professional service businesses, fifteen of them in dental and orthodontic operations, working with owners, executive teams, DSOs, and investors to turn operational complexity into disciplined execution, accountability, and durable enterprise value.

She has led operations directly for more than 120 practices across 350-plus offices, work that sits inside a wider total of 320 practices across 650 locations once the organizations she has advised and built infrastructure for are counted.

She started on the operations side, running and building practices. As private equity and strategic buyers moved into dental, she moved to the sell-side and spent four years as a broker, bringing practices to market, many of them practices she had helped build. She went on to provide operational support inside an operating platform and to co-found a franchise-like orthodontic model, designing the workflow, roles, onboarding, and performance standards that let independent orthodontists gain the advantages of a large DSO while keeping full ownership. That team onboarded 30 practices across 14 states in 18 months, past $25 million in net production. Since 2025 she has run operational due diligence and closing support for buy-side clients of an investment banking firm.

Orthodontics is her deepest expertise, and she works across general and multi-specialty dental as well. She is a Lean Six Sigma Green Belt in Healthcare. Every recommendation traces back to something she measured. She diagnoses the operational gaps that limit growth or put value at risk at sale, builds the fix, and develops the client's team to run it from day one.

Gretchen lives in Madisonville, Louisiana, with Eddie, her husband of 31 years. She loves to hike, travels often, and never turns down a chance to learn about another culture.

Ready to find the gaps and build value?

Tell us where the practice or the deal stands, and we will tell you what we would look at first.

Book my call