The Revisor’s § 332.081 landing page defaults to a version that does not take effect until August 28, 2026. Through August 27, use the 2018 version in the page’s “All versions” table. On August 28, the 2026 version inserts a new hospital-employment subsection 1 and renumbers the existing provisions.
1. CPOD status
Tier: Strict- Mo. Rev. Stat. § 332.071(10): the practice of dentistry includes any person or entity who “[d]irectly or indirectly owns, leases, operates, maintains, manages or conducts an office or establishment of any kind in which dental services or dental operations of any kind are performed for any purpose.” A carve-out covers real-estate owners leasing premises to qualified practitioners.
- § 332.071(11): the definition also includes anyone who “[c]ontrols, influences, attempts to control or influence, or otherwise interferes with the dentist’s independent professional judgment regarding the diagnosis or treatment of a dental disease, disorder, or physical condition.” Opinions from other licensed health professionals are excepted. Subdivision (16) captures reviewing examination findings, x-rays, or patient data to make judgments about dental care rendered in the state.
- Through August 27, 2026: § 332.081.1–.2; effective August 28: § 332.081.2–.3. No person or entity may practice dentistry or provide dental services without a Board certificate, license, or permit. A corporation may practice only under ch. 355 (with limits for a qualifying 501(c)(3)) or ch. 356, subject to enumerated institutional exceptions. Do not use the future subsection numbers for an opinion dated before August 28.
- Effective August 28, 2026: new § 332.081.1. Hospitals licensed under ch. 197 may employ dentists for specified emergent dental conditions, oral and maxillofacial surgeons for listed medically related oral conditions, and maxillofacial prosthodontists supporting complex-care or surgical teams. This does not create a DSO employment exception.
2. Other professions
This page covers dentistry only. Medicine, optometry, veterinary practice, and other professions are governed by different statutes and boards, even within the same state. For medical-practice sources, use the MSO-PC Wiki.3. Professional entity forms
Permitted forms: a professional corporation under Missouri’s Professional Corporation Law, ch. 356. Section 332.081.3 names chs. 355 and 356 as the only corporate forms. Section 356.111.1 limits share issuance to licensed natural persons and their qualifying revocable trusts, general partnerships of licensed persons, professional corporations, and LLCs whose members are all licensed. Section 356.111.3 voids nonconforming transfers but allows a transfer “by operation of law or court decree.” Open questions to verify with counsel: Section 332.081.3 refers only to corporations organized under ch. 355 or 356, so it does not clearly authorize an LLC as the practice entity. Hygienist ownership is also not expressly addressed, although entity permits under § 332.081.2 contemplate dental services by licensed dentists and hygienists. Also confirm before filing:- Naming rules, designator requirements, and any limits tied to licensed owners’ names; several states regulate dental trade names separately
- Board pre-approval or certificates, whether the dental board must act before (or after) the secretary of state will file
- Officer and director licensure, including states that restrict these roles as well as ownership to licensees
4. Fee structure
No Missouri statute located for this page bans percentage-of-collections management fees by name. The practice definition still controls: an MSA fee and service bundle that amounts to indirectly operating or managing the office under § 332.071(10), or influencing clinical judgment under § 332.071(11), may make the DSO an unlicensed practitioner regardless of the fee label. Verify the structure with Missouri counsel. For the MSA, test whether a percentage-of-collections fee is permitted under the state’s dental, fee-splitting, referral, tax, and contract rules. Several states expressly restrict revenue-linked dental management fees, and the Aspen Dental settlements imposed related party-specific terms. Flat and cost-plus formulas are not automatic safe harbors; the services, calculation, amount, control rights, and actual payments still matter. See Fee-splitting rules and Set the management fee.5. Noncompetes
No dental-specific noncompete statute was identified in this research; Missouri noncompetes are governed by general state law. Verify current Missouri law with counsel before including one. Federal noncompete policy changed substantially in 2025 and 2026. The FTC’s Non-Compete Rule was vacated, the agency dismissed its appeals in September 2025, and the rule was removed from 16 C.F.R. pt. 910 effective February 12, 2026. State law remains central. Dental enforcement resolutions in New York and California have also restricted noncompetes for the settling parties as a corporate-practice remedy. Verify the current rule, worker, agreement type, transaction context, effective date, and remedy in this state. See the legislation tracker.6. DSO-specific law and registration
None by name. There is no registration or disclosure regime. The statutory DSO boundary includes:- Through August 27: § 332.081.4; effective August 28: § 332.081.5. A dentist may not enter a contract allowing a nondentist to influence or interfere with independent professional judgment.
- Through August 27: § 332.081.5; effective August 28: § 332.081.6. Nonprofits and “any other person” may not direct or interfere with a dentist’s professional judgment. Enforcing employment contracts, corporate policy and procedure manuals, and quality-improvement or quality-assurance requirements is expressly not unlawful.
7. Death and transition window
No estate or deceased-dentist transition provision was located in ch. 332. Disposition of a deceased dentist’s PC shares runs through the ch. 356 mechanics. Section 356.111.3 permits transfer “by operation of law or court decree,” but no statutory continuation period appears. Verify the practical timeline with counsel.8. Practical structuring notes
Missouri’s “indirectly owns… manages or conducts” language is among the broadest proprietor clauses in the country, and subdivision (11) extends it from control to mere influence. The safe course is an MSA documenting recommendation-and-consent workflows (the dentist decides; the DSO advises and executes), using the statutory carve-outs for employment contracts, policy manuals, and QA programs as hooks for legitimate functions. Calendar the August 28 renumbering in templates and opinion forms; the substance of those control provisions remains, but their subsection numbers move.9. Verification checklist
- Confirmed the permitted entity form for dentistry in this state
- Confirmed whether dental board pre-approval or a certificate is required before filing
- Confirmed whether officers and directors must be licensed dentists
- Confirmed the management fee structure is lawful here, including any restriction on revenue-linked fees
- Clinical carve-out drafted against this state’s current statutory language, including any enumerated control prohibitions
- Transfer restriction and succession documents checked against this state’s death-transition window
- Noncompete provisions checked against current state law
- DSO foreign-qualified before it has employees here
- Any DSO registration, licensure, or disclosure obligation identified and calendared
- Trade-name and advertising-disclosure rules for dental practices checked
10. Sources
For the cases and statutes referenced above, see DSO & dental case law and the 51-jurisdiction table. For enacted and pending legislation, see the dental legislation tracker.