Scaling a Multi-Location Dental Practice with PPC

Growing from one dental office to three, five, or ten locations changes everything about how you run paid ads. The strategies that filled chairs at a single practice start breaking down the moment you add a second location with its own zip codes, its own competition, and its own patient demographics. Most multi-location dental groups we work with come to us after discovering this the hard way: they duplicated their single-location campaigns, spread the budget across offices, and watched cost per lead climb while new patient volume stalled.

The good news is that PPC for dentists at scale is one of the highest-ROI marketing channels available when you structure it correctly. Multi-location dental groups that get the fundamentals right routinely see 30-50% lower CPLs than groups that treat every location like a copy-paste job. This guide covers exactly how we structure, budget, and optimize Google Ads for dental practices operating across multiple markets.

Individual Location Budgets vs. a Shared Budget

The first question every multi-location dental group asks is whether to pool budget across all locations or assign dedicated budgets per office. The answer is almost always dedicated budgets per location, and here is why.

Why Shared Budgets Fail

When you run a shared budget across five locations, Google's algorithm will naturally funnel spend toward whichever location or geo area produces the cheapest clicks. That sounds efficient until you realize your newest location in a competitive suburb is getting starved of spend while your established office in a smaller town absorbs the majority of impressions. The result is lopsided growth: your strong locations get stronger and your weak locations never get the volume they need to ramp up.

How to Allocate Budgets by Location

We use a framework based on three factors:

• Market opportunity: How many monthly searches exist for dental keywords in each location's radius? A location in a metro area of 500,000 people deserves more budget than one in a town of 40,000.
• Practice maturity: New locations need heavier investment in the first 6-12 months to build patient volume. We typically allocate 20-40% more budget to locations in their first year.
• Service mix: Locations focused on high-value procedures like implants or cosmetic dentistry justify higher spend because the revenue per new patient is 3-10x higher than general cleanings.

A practical starting point for most multi-location dental groups:

These ranges assume competitive U.S. markets with proper conversion tracking and optimized landing pages. Your actual numbers will vary by city and competitive density.

Geo-Targeting Strategies That Actually Work

Geo-targeting is the backbone of multi-location PPC. Get it wrong and your locations cannibalize each other's spend. Get it right and each office dominates its local market without wasting a dollar on the wrong zip codes.

Setting Radius and Zip Code Targets

For most dental practices, patients are willing to drive 10-15 minutes. In metro areas, that might be a 5-8 mile radius. In suburban or rural areas, it could stretch to 15-25 miles. We set targeting based on actual drive-time data, not arbitrary radiuses.

Key rules we follow:

• Eliminate overlap between locations. If two offices are 12 miles apart, carve the geo boundary so each location owns its side. Overlapping geos mean you're bidding against yourself.
• Use "Presence" targeting, not "Presence or Interest." Google's default setting shows ads to people who are "in or interested in" your target area. That means someone in another state searching "dentist in Phoenix" could trigger your ad and waste budget. Switch to "Presence: People in or regularly in your targeted locations" for every campaign.
• Layer zip code bid adjustments. Not all zip codes within your radius are equal. Zip codes with higher household incomes or denser populations often convert better for high-value services. We increase bids 15-30% in premium zip codes and decrease them in areas that historically underperform.

Handling the Gaps Between Locations

Some patients fall between two of your offices. Rather than ignoring these areas, create a "shared zone" campaign that dynamically directs patients to the nearest location using ad customizers. The ad copy and landing page adjust based on the searcher's location, pointing them to the office closest to them.

Location-Specific Ad Copy and Landing Pages

Running the same ad copy and landing page for every location is one of the fastest ways to tank your quality scores and conversion rates. Patients expect to see their city, their neighborhood, and their specific office when they click an ad.

Ad Copy That Converts by Location

Every location should have ad copy that includes:

• City or neighborhood name in the headline. "Top Dentist in Scottsdale" performs dramatically better than "Top Dentist Near You."
• Location-specific offers. If your Scottsdale office runs a $99 new patient special but your Mesa office offers $149, the ads must reflect that. Mismatched offers destroy trust when a patient calls and hears a different price.
• Office-specific proof points. "4.9 Stars From 380+ Reviews" for the office the patient will actually visit, not an aggregated rating across all locations.

Building Local Landing Pages Per Location

Each office needs its own dedicated landing page. This is non-negotiable. A single "Our Locations" page with a dropdown menu converts at roughly 3-5%. A dedicated location landing page with the right elements converts at 10-18%.

What every location landing page needs:

• The office address, phone number, and Google Maps embed
• Photos of the actual office and staff (not stock photos)
• Reviews from patients who visited that specific location
• The location-specific offer with a clear CTA
• Office hours and accepted insurance plans for that location
• Schema markup with LocalBusiness structured data

Ready to build high-converting landing pages for every location? Our team builds location-specific PPC funnels that turn clicks into booked appointments. See how we handle PPC for dentists or get in touch for a free multi-location audit.

MCC vs. Single Account: Choosing the Right Structure

Google Ads offers two paths for multi-location management: a single account with location-based campaigns, or a Manager Account (MCC) with separate sub-accounts per location. The right choice depends on how many locations you operate and how different they are.

When a Single Account Works

A single Google Ads account with location-segmented campaigns works well when:

• You have 2-4 locations in the same metro area
• All locations offer the same services at similar price points
• One person or team manages all PPC activity
• You want simplified reporting and shared conversion data

The advantage is simplicity. You manage one account, one billing setup, and one set of audience lists. Remarketing pools are shared, which means a patient who visited your website from Location A can be retargeted even if they later search near Location B.

When You Need an MCC

A Manager Account with separate sub-accounts becomes necessary when:

• You have 5+ locations, especially across different cities or states
• Locations have significantly different service offerings or pricing
• Different teams or franchisees need access to their own data
• You need per-location billing or separate budget controls
• Some locations participate in co-op advertising programs

The MCC structure keeps each location's data clean and prevents performance in one account from dragging down or inflating metrics in another. It also makes it easier to pause or restructure a single location without disrupting the others.

For groups with 5-15 locations, we almost always recommend the MCC approach. The slight increase in management overhead is worth the clarity and control it provides.

Managing Quality Score Across Locations

Quality Score in a multi-location setup can diverge wildly. One office might sit at 8/10 for "emergency dentist" while another hovers at 5/10 for the same keyword. This happens because Quality Score is influenced by the landing page, ad relevance, and expected CTR at the individual ad and keyword level.

Common Causes of Quality Score Disparity

• Generic landing pages. If Location B uses a shared landing page instead of a dedicated one, its landing page experience score drops.
• Thin ad groups. Locations with fewer ad variations tend to have lower expected CTR because Google has less data to optimize with.
• Low search volume areas. Locations in smaller markets may not generate enough impressions for Google to confidently score keywords, leading to default or below-average scores.

How to Equalize Quality Scores

• Build dedicated landing pages per location (as covered above)
• Write at least 3-4 responsive search ad variations per ad group, per location
• Use ad extensions (sitelinks, callouts, structured snippets) customized to each office
• Monitor Quality Score weekly and flag any keyword that drops below 6/10 for immediate review

Handling Performance Disparity Between Locations

It is completely normal for some locations to outperform others. The mistake is ignoring the disparity or assuming it will resolve itself. In our experience managing multi-location dental groups, the top-performing location typically produces 2-3x the new patients per dollar compared to the weakest.

Diagnosing the Gap

When one location lags, we investigate in this order:

1. Phone answer rate. If the front desk at Location C only answers 60% of calls while Location A answers 92%, no amount of ad spend fixes that. We track call answer rates for every location using call tracking software.
2. Landing page conversion rate. Compare conversion rates across location pages. A 2-3% gap is significant and usually points to weak offers, slow load times, or missing trust signals.
3. Review volume and rating. Offices with fewer than 50 Google reviews or ratings below 4.5 stars see measurably lower CTRs and conversion rates.
4. Competitive density. Some locations face 15 competing advertisers while others face 5. Higher competition means higher CPCs and a harder fight for impression share.

Rebalancing the Portfolio

Rather than pulling budget from weak locations (which only widens the gap), we address root causes first. Fix the phone handling, improve the landing page, build up reviews, and then reassess after 30-60 days. If a location still underperforms after resolving operational issues, then we consider reallocating 10-20% of its budget toward higher-performing offices while maintaining a baseline presence.

Reporting and KPIs for Multi-Location Dental PPC

Centralized reporting is critical. Every stakeholder, whether it is the dental group's CEO, the office managers, or the marketing team, needs to see the same data in a consistent format.

We track these KPIs per location, weekly:

• Cost per lead (CPL) by procedure type
• Cost per acquisition (CPA) -- what it costs to get a patient in the chair, not just a phone call
• Phone answer rate and call-to-appointment conversion rate
• Impression share -- how often your ads appear vs. how often they could
• Quality Score trends for top 10 keywords
• New patient revenue attributed to PPC (requires closed-loop tracking with practice management software)

Rolling all locations into one dashboard with location-level drill-down gives leadership the full picture while giving individual office managers accountability over their own numbers.

Key Takeaways

Scaling PPC across multiple dental locations is not about multiplying a single campaign by the number of offices. It requires dedicated budgets, precise geo-targeting, location-specific creative, and the right account structure. The dental groups that win at multi-location PPC treat each office as its own micro-market while maintaining centralized strategy and reporting.

The biggest levers for multi-location dental PPC success:

• Allocate budgets per location based on market size, maturity, and service mix
• Eliminate geo overlap and use "Presence" targeting only
• Build dedicated landing pages for every office with local proof points
• Choose MCC for 5+ locations, single account for 2-4
• Monitor Quality Score and performance disparity weekly
• Fix operational issues (phone handling, reviews) before reallocating budget

Managing PPC for a multi-location dental practice is complex, but you do not have to figure it out alone. We specialize in scaling dental PPC campaigns across 2 to 20+ locations with transparent reporting and measurable results. Contact us for a free multi-location PPC audit and we will show you exactly where your budget is being wasted and where the growth opportunities are.