Washington’s rules come from RCW ch. 18.32, the Dental Quality Assurance Commission, and the Uniform Disciplinary Act. Check the legislation tracker for pending changes.
1. CPOD status
Tier: Moderate, with express statutory permissions and control limits The baseline is a proprietor clause. Under RCW 18.32.020(3), a person practices dentistry by owning, maintaining, or operating an office for the practice of dentistry. The provision dates to 1935. RCW 18.32.675 is captioned “Practice or solicitation by corporations prohibited—Penalty.”1 The 2017 reform rewrote § 18.32.675. SSB 5322 (ch. 320, Laws of 2017, effective July 23, 2017, refined by 2018 c 210) separately allows a person or entity not licensed by the commission to:2- Hold ownership or leasehold of the assets used by a dental practice, including real property, furnishings, equipment, instruments, materials, supplies, and inventory, but excluding dental records
- Employ or contract for personnel other than the licensed and registered dental professionals listed in subsection (2)(b)(i)
- Provide business support and management services, including as the sole provider
- Receive fees calculated as agreed to by the dental practice owner or owners for the permitted assets, personnel, and services
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
Dentist-owned practices organize under Washington’s professional service corporation act, RCW ch. 18.100. Verify the pinpoints with counsel. Patient records must remain with the practice and its licensees; the 2017 framework expressly excludes records from the assets a lay entity may own.2 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
RCW 18.32.675(2)(d) permits fees for the subsection’s allowed assets, personnel, and support services “calculated as agreed to by the dental practice owner or owners.” It does not impose the federal safe-harbor formula on those ordinary arrangements. The fee still must respect Washington’s control line and any independently applicable state or federal law; the special nonprofit integrated-care path in subsection (2)(b)(ii) has its own safe-harbor conditions. 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
Dentist noncompetes in Washington are governed by the state’s noncompetition covenant statute, which imposes an earnings threshold and other conditions that change annually. Verify current figures with counsel before drafting 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
Washington’s 2017 act expressly permits specified DSO arrangements and imposes no DSO registration requirement. RCW 18.32.675 authorizes listed asset, staffing, and support arrangements. RCW 18.32.677 (2017 c 320 § 3) lists ten forms of prohibited nonlicensee interference with a dentist’s independent clinical judgment:3- Limits or requirements on patient time, patient volume, or procedure volume
- Limits or requirements on a course or alternative course of treatment or how treatment is carried out
- Limits or requirements on how the dentist uses equipment or materials
- Limits or requirements on laboratories, materials, supplies, instruments, or equipment the dentist considers reasonably necessary
- Limits or requirements on professional training the dentist considers reasonably necessary
- Limits or requirements on referrals to specialists or other practitioners
- Interference with the dentist’s access to patient records at any time
- Interference with the dentist’s refund decision
- Advertising requirements that would cause the practice to violate specified dental or disciplinary law
- Limits or requirements on communications with the dentist’s patients
7. Death and transition window
Washington’s professional-service-corporation statute supplies a 12-month transition rule. Under RCW 18.100.116, shares held after a shareholder’s death or ineligibility must be transferred or redeemed within 12 months; after that period they are cancelled, while the former holder retains the right to fair-value payment. RCW 18.100.118 permits a fiduciary of an estate holding all shares to serve as director, officer, and shareholder for no more than 12 months. Professional LLCs are subject to the chapter 18.100 provisions applicable to professional corporations under RCW 25.15.046(2). See Plan for succession.8. Practical structuring notes
Draft from the statutory subsections. The statute identifies which assets a support company may own or lease, which personnel it may employ, which support services it may provide, how the parties may agree on fees, and ten subjects it may not control. Analyze the nonprofit integrated-care exception and its federal safe-harbor conditions separately from the ordinary DSO permissions. Compare the MSA and operating delegation matrix with the actual subsections.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 and where to verify
Entity formation runs through the Washington Secretary of State; commission rules through the Dental Quality Assurance Commission (DOH); pending bills through the Washington Legislature.
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.