The systems for doing marketing were partially in place. The systems for measuring and improving it were not.
When I came on board in November 2025, Keyzer Family Dentistry was in good shape where it counts. Two busy offices, a great team, patients who liked being there. The marketing side just needed a fresh start. Their previous agency had recently parted ways and taken the marketing infrastructure with them, including the ad account, the CRM, and most of the visibility into what had been running.
What that meant in practice: the website had no analytics installed, no Meta Pixel, and no structured data telling Google where the offices were located. The online appointment form had a bug that was quietly dropping submissions before they reached the team. The practice wasn't running any paid ads at the time, and the direct mail they'd done in the past had never been measured. So there wasn't a clear picture of what was working.
Dr. Keyzer and her team were doing what good practices do: focusing on the patients in the chair. The marketing side just needed someone whose full job was to look at it.
The Starting Point
How One Bradenton Dental Practice Grew Online Inquiries Nearly 5x in Five Months
CASE STUDY · 2026
Every dollar the practice spends should produce a number we can find, attribute, and compare to the next month.
New HTML appointment confirmations and 24-hour reminders, customized per location, deployed in Open Dental. SMS copy refreshed for key moments in the patient journey.
Patient communications
Two location campaigns. The first paid advertising the practice had ever run.
Google Ads campaigns built and launched
Across both offices, including categories, services, photos, posts, and weekly review responses in a consistent voice.
Google Business Profile cleanup and ongoing management
Rewritten and rebuilt as the primary landing surfaces for paid and local search traffic.
New location pages
Structured data for both locations, making the office addresses, hours, and contact information machine-readable for Google.
Local business JSON-LD schema
Implemented site-wide, with a workaround for a Chrome prerendering issue that was inflating pageview counts. A traffic-cop pattern that holds the pixel fire until a real human shows up.
Meta Pixel and Google Tag Manager
Installed from scratch, with appointment-request event tracking split into phone taps and online form submissions, plus custom dimensions for location attribution.
Google Analytics 4
I won't walk through every line of code, but here's the short list of what got built:
What I Built in the First Five Months
Part of the work this period was rebuilding the practice's patient communication: new HTML appointment confirmations and reminders, plus a refresh of the SMS copy that goes out at key moments in the patient journey.
One of those SMS messages is the one that asks happy patients to leave a Google review, and it goes out automatically when the front desk marks a patient as “out the door” in Open Dental. While I was working through that flow, I noticed at Manatee Avenue that the review requests mostly weren't going out. The cause turned out to be visual, not procedural. Open Dental was showing the “in treatment” status as dark blue and the “out the door” status as black, which look nearly identical at a glance on a busy front-desk screen. The team was checking patients out, just not always with the click that triggered the automation. I changed the status colors so the two are easy to tell apart at a glance, and the workflow snapped into place.
April was the result: 20 reviews in a single month at Manatee Avenue. 59th Street had been running the workflow correctly all along, and its review pace roughly doubled across the period once a consistent response cadence was in place. The 59th Street profile picked up 100 reviews during the engagement, and both offices now have a steady stream of recent, fresh patient feedback.
Reviews and Reputation
The practice had done direct mail in the past but had never tracked the results. In March, I brought in a new vendor and ran a fresh mailer aimed at new-patient acquisition for one office. The vendor reported a 7.36x ROAS based on lifetime-value math ($2,200 average per patient). That number isn't wrong. Patients do produce revenue over years. But it's not what hit the bank account in the 60 days after the mailer dropped, which is what most practice owners actually need to plan around.
So, I pulled each of the 15 new patients the mailer produced, looked up the procedures they had done, and calculated a true 90-day ROAS of 1.66x: $7,430 in collected revenue against $4,486 in mailer cost, for a net cash position of $2,943 in the practice's pocket. I track both because they answer different questions for a practice owner. Lifetime value justifies the cost of acquiring a patient today by projecting the collections they will bring over the next five years. The 90-day ROAS proves the campaign is financially sustainable today, ensuring immediate collections can comfortably fund the next mailer.
Direct Mail
Phone-tap volume from the website tripled in March, and a spot check of one month of ad-driven phone calls suggested roughly half were new patients. Neither figure is in the published ROAS, so the real ceiling is higher than either number shown above. But I publish only what I can tie to a specific patient.
The Manatee Avenue campaign produced more raw leads but booked fewer of them. That's the kind of pattern you only see when you're looking at the whole funnel, not just the ad metrics. I brought it to Dr. Keyzer with the lead-status data showing the gap between the two locations, and together we built a plan to address it with the front-desk team. The next analysis cycle will tell us how much the operational fix recovered.
I launched paid search in mid-December, the first time the practice had ever run Google Ads. Five months in, the 59th Street campaign is where the story is most clearly told.
On directly attributable online-form revenue collected in the 90 days after each booking, the 59th Street campaign produced a 1.85x Return on Ad Spend (ROAS). Applying the same lifetime-value methodology the mailer vendor used ($2,200 per patient, applied to the 10 patients who actually showed up), the projected lifetime ROAS on the same campaign comes to 4.42x. Both numbers are real, calculated the same way they're calculated for every other channel in this case study. The actual sits at the floor; the lifetime sits in the middle of the 3–5x range most dental practices target for paid search. Combined across both offices, those figures are 1.31x actual and 3.30x lifetime projected.
Paid Search
The first week I started, I found and fixed a bug in the appointment form that had been quietly dropping submissions. Once it was working, 10 leads came in by the end of November. December more than doubled that. By January, with most of the foundational work in place, we hit 48 form submissions. February held at 47.
March is when Bradenton hits its busiest stretch of the year, with seasonal residents at peak presence and patients in scheduling mode. Form submissions stayed strong at 40, but the bigger move was on tap-to-call from the website: 95 in March alone, more than triple December's 27. By April, the practice was pulling in 35 form submissions and 56 tap-to-call events from the site.
Across the five-month period (December through April), the website drove 193 form submissions and 267 tap-to-call events. 460 total patient inquiries from a site that hadn't been tracking any of this before.
Online Inquiries
The new location pages I built quickly became the second and third most-visited pages on the entire site. From December through April, they brought in a combined 1,515 new users, more than the homepage itself. Average engagement time on those pages sits at 43 to 48 seconds, which is solid for a local services site and tells me people are actually reading them, not just bouncing.
Website Performance
Most agencies don't bother with Apple's local ecosystem, but a lot of iPhone users in Florida find local businesses through Apple Maps instead of Google.
After the optimizations, 59th Street's monthly Apple Maps search taps grew from an average of 52 (May to Nov 2025) to 85 (Dec 2025 to Apr 2026), a 63% lift. Manatee Avenue moved from an average of 71 to 84 in the same window, with a peak of 102 search taps in April.
Apple Business Connect
Across both locations, roughly +36% in total Google Business Profile interactions year over year, and website clicks from local search nearly doubled combined.
Dec 2025 to Apr 2026 compared to the same period a year earlier.
Google Business Profile
Results, One Channel at a Time
He finds problems I didn't know we had, fixes them, and then walks me through the numbers so I understand what changed and why. I can actually trust that my money spent turns into real patients in the chair.
- Dr. Noel Keyzer, DMD