2.8x ROAS Across 6 Locations — Unified, Measurable, Scalable
A Texas dental group ran six locations as six disconnected marketing efforts. Each office had strong clinical teams and loyal local patients, but no shared infrastructure tied the group together.
Consolidating reporting, ad management, and location-level SEO turned fragmented spend into one coordinated growth engine — with a single view of what every dollar produced across all six markets.
A Growing Group Without Shared Infrastructure
The group's ambition was straightforward: scale to more locations without losing control of marketing performance. Each office served its own neighborhood market with general and cosmetic dentistry, and leadership wanted a predictable new-patient pipeline across all of them. What was missing was a shared system — three agencies managed different subsets of locations, each with its own reporting cadence and definition of success.
Six Locations, Six Different Stories
Every month, leadership received separate reports in separate formats from separate agencies. Comparing performance between locations required manual spreadsheet work that nobody had time to do consistently.
Because each agency defined a "lead" differently, the numbers could not be trusted side by side. One location looked like a top performer purely because form fills and calls were counted more generously there.
Branding drifted too. Ads, websites, and Google Business Profiles used different messaging and imagery, so patients in adjacent markets encountered what felt like different practices.
As the group looked to scale, the bottleneck was never patient demand or clinical capacity — it was the inability to see clearly enough to make good decisions.
What Was Holding the Group Back
An infrastructure audit across all six ad accounts, analytics setups, and Google Business Profiles surfaced problems nobody could see from inside a single location.
- Three agencies, three conflicting definitions of a lead
- No cross-location reporting or shared metrics
- $4,200/month lost to duplicate keywords and broad match
- Inconsistent branding across ads, sites, and profiles
None of these were dramatic failures on their own. Together they made it impossible to know which locations deserved more budget and which needed structural fixes.
The Dashboard Changed the Conversation
The first time leadership saw all six locations on one screen, a location long written off as "underperforming" turned out to be losing budget to duplicate keyword bidding — not lacking patient demand. Visibility, not more spend, was the unlock.
Building One Growth Engine From Six
Vigorant consolidated the group's marketing infrastructure before changing a single campaign budget.
Infrastructure Audit
Audited all 6 ad accounts, analytics setups, and Google Business Profiles; identified $4,200/month in wasted spend from duplicate keywords and broad-match inefficiency.
Unified Dashboard
Built one real-time dashboard aggregating all 6 locations — cost-per-lead, conversion rate, review velocity, and organic visibility score per location.
Location-Specific SEO
Deployed individual SEO strategies per location based on local competitive analysis, each targeting neighborhood-specific keyword clusters.
Consolidated Ads
Merged ad accounts under unified management with shared negative keyword lists, cross-location audience learnings, and unified creative testing.
The Business Impact
Within six months, the group's spend and results were finally measured on the same terms.
The numbers changed how leadership made decisions. Budget moved toward the markets that could absorb it, underperforming locations got structural fixes instead of more spend, and expansion planning rested on attribution rather than instinct.
“We finally know where every dollar goes and what it produces. That visibility alone changed how we make decisions.”
What This Means Going Forward
Within 6 months, the DSO had eliminated redundant spend, unified reporting, and scaled to 89 net new patients per month across all locations — with a clear attribution model showing exactly which locations and channels drove growth.
The six locations were never the problem. What was missing was a single system to see and manage them as one business.
Frequently Asked Questions
Yes. Multi-location dental groups and DSOs are core to the portfolio, including unified reporting, consolidated ad management, and location-specific SEO under one framework.
Budget spent on keywords, audiences, or placements that generate clicks but no qualified patient leads — usually from broad match, duplicate keywords, or missing negative keyword lists.
Brand standards apply across ad creative, website copy, Google Business Profiles, and review responses, while still allowing location-specific messaging where local markets differ.
A unified dashboard typically produces trustworthy cross-location comparisons within the first full reporting month, once tracking definitions are standardized across every account.
Disclaimer: To protect client confidentiality and privacy, the name of the healthcare provider, practice, and any other identifying details presented in this case study have been fictionalized or anonymized. Any names, practice identifiers, or other details that could reasonably be used to identify an individual or organization have been modified for confidentiality purposes.