Medical & Dental TI Build-Outs
A medical or dental TI build-out turns a leased commercial suite into a working practice — operatories, exam rooms, sterilization, and the plumbing and power density they bring — inside a landlord’s work letter. Grandview Contractors builds them across Utah County and Salt Lake County under a Utah DOPL B100 general contractor license, pricing the gap between an office allowance and a clinical build before the lease is final.
When a medical or dental TI is the right project
This is the page for a practice leasing a suite in a medical office building, a retail strip, or a general office building that needs to be a clinic by a commencement date. The landlord’s allowance was sized for drywall, carpet, and a break-room sink, not six operatories with vacuum lines under the slab.
If your suite is a general office, our office build-out page is the better read. If the space was already a clinic, our second-generation retrofit page covers what can be reused — with one warning: existing operatory plumbing rarely lands where a new chair layout wants it. Landlords delivering a medical-ready suite should see landlord work-letter build-outs. Clinical specifics by practice type live on our medical and dental build-out pages; this page is the lease side of a clinical tenant improvement.
Why a clinic outgrows a standard TI allowance
An office TI puts water in two places. A dental TI puts supply, drain, vacuum, and compressed air at every chair, plus a sterilization center and a mechanical room for the compressor and vacuum pump. In a slab-on-grade strip building that means saw-cutting and trenching along the operatory runs. On an upper floor of a medical office building it means coring a post-tensioned deck, which needs the building’s structural engineer to locate tendons and sign off first. We ask for that approval in the work letter, not in week three.
Slab work has a Utah wrinkle. Much of the Wasatch Front sits on expansive clay or collapsible bench soils, so trench backfill is compacted in lifts and the patch is doweled to the existing slab; a settled patch shows up later as cracked tile under a chair. Utah’s hard water is the other quiet one: sterilizers and dental units want treated water, so filtration is planned into the plumbing run.
Power and air follow the same pattern. A shell suite carries a modest sub-feed; sterilizers, compressors, and a panoramic or CBCT unit can push past it, and the base building may not have spare capacity. Exam rooms are small closed rooms with their own ventilation needs, while the landlord’s rooftop unit was zoned for open office, so rezoning, sterilization exhaust, and a roof penetration or two become line items. X-ray rooms add lead-lined drywall and doors. Near the Wasatch fault, imaging equipment and tall casework get anchorage detailed to current Utah-adopted code, because plan reviewers here check for it.
Grandview self-performs the general-contracting core: demolition, framing, drywall, doors and hardware, casework, and finish carpentry. Electrical, plumbing, HVAC, fire suppression, and medical gas are performed by licensed trade contractors; Grandview holds the contract and manages them, sequencing rough-ins against the chair layout and quality-checking the work (see MEP coordination). Patient-facing spaces are checked against the ADA standards for accessible design during layout — exam room clearances, restroom turning radius, counter heights — with our accessibility retrofit work covering the details.
What the work letter does and doesn’t cover for a clinical suite
Medical office buildings often deliver a heavier base building — extra plumbing stubs, a larger feed, a higher allowance — because the landlord expects clinical tenants. Office and retail landlords usually don’t. Either way, a clinical build-out needs rights a standard work letter rarely spells out: trenching or coring the slab, roof penetrations for exhaust and compressor venting, added electrical capacity, after-hours windows for saw-cutting. We review the work letter for those items before signing so they get negotiated, not discovered. Allowance draw packages run the same as any TI; clinical suites just generate more paper.
- Walk the shell with the equipment plan. Chair count, imaging placement, and sterilization layout come first; the slab, panel, and ductwork questions hang off them.
- Price the gap. A budget range against the allowance before the lease is final; an estimate and proposal once drawings are set.
- Plans review. Clinical suites go through commercial plan check. Provo, Orem, and Salt Lake City run predictable queues; Lehi and Saratoga Springs can be quick on some reviews and stacked on others. One statewide B100 license covers it all, verifiable at dopl.utah.gov.
- Build and close. Slab work and rough-ins first, chair-vendor site visits where their dimensions matter, then finals sequenced so the certificate of occupancy lands before the equipment install date. Problems happen. Surprises should not.
What does a medical or dental TI cost in Utah?
As ballpark planning numbers only, never a quote: a clinical suite built from a vanilla shell along the Wasatch Front commonly runs $150–$300 per square foot for construction, against $50–$100 for a standard office TI. Dental trends toward the upper half because cost scales with chair count more than square footage. Equipment is separate and often rivals the construction number.
What moves the number: chairs or exam rooms per square foot; slab trenching versus deck coring; a panel upgrade; HVAC rezoning and exhaust; lead shielding; casework and finish level; and after-hours restrictions, which add labor premiums on the noisy phases. Your real number comes from a scoped estimate against your allowance.
Questions we actually get
Will a standard office allowance cover a dental build-out?
Rarely. An office allowance covers a fraction of a clinical build, because operatory plumbing, panel capacity, and HVAC rezoning are not in an office pro forma. Price the gap before you sign, then negotiate a higher allowance, free rent, or amortized landlord funding against a real number.
Can you trench the slab in a leased suite?
Usually, with the landlord’s written approval in the work letter. Slab-on-grade suites are straightforward: saw-cut, trench, run lines, compact backfill, dowel the patch to the existing slab. Upper floors of a medical office building need the structural engineer to locate tendons and approve core locations first, which adds review time.
Do we need our equipment chosen before design starts?
Yes, at least the make and model of anything touching plumbing, power, or structure. Chairs, sterilizers, compressors, and imaging units come with rough-in drawings, and the slab trenches and circuits are laid out from them. Choosing equipment after rough-in means moving lines in concrete, the most expensive place to move anything.
Tell us what you’re working on
Send us the work letter and a chair count. We reply within a couple of hours during business hours — a day at most — with a straight read on the allowance gap, the slab and power questions, and a realistic schedule for your city. More of this work lives in our renovation and build-out family.