The short answer
Local Services Ads charge for a valid lead, and Google offers them only in certain categories. Dentist is on that category list, and you still check eligibility for each area. Each office is its own provider account, with its own verification and its own matching Business Profile, and the group runs those accounts from one manager account. When offices serve the same area, Google shows only the highest ranking ad, so set each service area before you set budgets. Keep Search campaigns running beside these ads.
A marketing or operations lead at a dental group of about 3 to 50 or more offices decides this office by office. This is marketing guidance, not legal or compliance advice. The examples use three sample offices: Oak Park, Pine Hill, and Elm Street. For the other jobs a group handles, see marketing a multi-location practice or DSO.
Health care limits
The getting started page describes leads as phone calls, messages, and bookings. Health care verticals do not get that full set. Plan the office around phone calls.
How leads work says lead credits and call recordings are not available for health care verticals in the United States. Automated lead credits says the same.
Manage leads and jobs says message leads are not available for health care. Getting started adds that booking leads and pre-badge ads are not available for health care either.
A valid phone lead, on the how leads work page, includes a call you answer, or a call you return and actually speak on. It also includes a missed call during business hours when the caller stays on the line for more than 20 seconds. If someone answers, even after 20 seconds of ringing, the charge is based on the conversation, not on the ring time.
Business hours are the hours on the Google Business Profile. If an ad schedule differs from those hours, an unanswered call is charged only when it falls inside both the active ad schedule and the business hours. Holiday hours belong on that profile too. See holiday and special hours.
If an automated menu asks the caller to press a key, the 20-second timer starts after the first key press. A caller who hangs up without pressing a key is not charged, even if the menu played longer than 20 seconds. Extra key presses do not reset the timer. A call that reaches voicemail or an automated greeting during business hours is treated as a connected call when the caller stays for more than 20 seconds, whether or not they leave a message.
Once a lead is charged, another call from the same number is not charged again when there is contact within 15 days. After 15 days with no activity, a new call can be a new lead. The number on the ad is a Google forwarding number that rings the business number. You do not pick that tracking number. If the office line already forwards or uses VoIP, the "Call from Google" whisper may not play.
About ad rankings says missed calls may hurt responsiveness. Getting started says that regularly failing to answer calls, or to respond to messages, may affect ranking. Message leads are not an option for health care, so the answering plan is the lever you have. Who picks up at each door is in office phones or a central team.
Verification for each office
Screening and verification says every business has to pass Google's checks, and that the checks vary by category and location. Follow the steps in your dashboard for that office.
For health care verticals in the United States, NPI verification is a prerequisite to serve ads. Google checks the National Provider Identifier through the NPPES NPI Registry. The same page says a business can have more than one NPI and an individual can have only one. If none is found, or more than one is found, the page says to contact Local Services Ads support from the account.
License checks, when they apply, are per location. The page says a business serving multiple locations must provide business and employee licenses for each location. The licenses Google verifies can show on the provider profile. Confirm what the dashboard lists for that office. Do not copy one office's upload onto the next door.
The ad has to match a Business Profile. The person completing the checks must be an owner or manager of that profile, even when someone else already verified it. If the signed-in user is not an owner or manager, the dashboard offers a way to request access, and the ad cannot show until that step is done. Who may own a profile is in Business Profile governance.
Manager account and access
Our practice: one provider account per office. Oak Park, Pine Hill, and Elm Street are three accounts. Each one carries its own verification, its own profile match, its own service area, and its own budget.
Bulk account creation is available only on a manager account. You download a CSV template, put one provider on each row, and upload it. The limit is 100 providers in one upload. A file with more than 100 rows is rejected. Each complete, valid row becomes an account.
A Google Ads manager account is a separate account that lets you view and manage other accounts, including other manager accounts, from one sign-in. It can link to a payments profile for monthly invoicing. Manage access says Local Services manager accounts are set up in Google Ads. You cannot create or edit them inside the Local Services screens. Linking to a manager account is required for consolidated monthly billing.
The group owns the manager account. A vendor gets a seat and an access level, such as standard or administrative. Administrative access can manage users. Billing access is also controlled on the payments profile, separate from the Local Services role. How to take a seat back when a firm changes is in switching a dental marketing agency.
Service areas and overlap
The ranking page says that if a business has multiple locations serving the same geographic area, Local Services shows only the highest ranking ad for that search. Two offices can both be eligible and still produce one ad.
Edit service areas and job types lets you include or exclude a county, a city, or a ZIP code. Give each office the area it can actually serve. If Oak Park and Pine Hill both include the same ZIP, only one of those ads can show for a search in that ZIP. Share a ZIP only when the group means for that contest to happen.
Set the service areas before you set weekly budgets. Spend on a second office in the same ZIPs still produces one ad, the higher ranking one. It does not buy a second placement in that overlap.
Broad search starts on. The ad can then serve for a category search that does not name a service, and the page uses "dentist near me" as the example. You can turn broad search off. Google says that may decrease leads, because those category queries stop. Off is a fit when you want leads only from searches that name a service. If one account covers more than one industry, turning it off applies to every industry on that account.
What goes into ranking
Listings are ordered by an auction. The ranking page names three inputs. Your bid is the most you are willing to pay for a lead, and you may pay less. The chance of a lead depends on responsiveness, on the search (the service, the time, the place), and on how relevant your services and bio are. Profile quality includes the rating, the review count, the average response time, high-quality photos, the checks you have finished, and other details that can affect what a person prefers.
The same page says providers with equivalent quality and budgets who use the Maximize Leads bid mode typically get more leads than those who do not. Google does not promise any office a given position. The page also says higher quality profiles may rank higher and may pay lower costs per lead. Treat that as a reason to finish the profile, not as a rate card.
Message leads and booking leads are another path the ranking page mentions for nights and weekends. Those lead types are not available for health care, so they are not a dental plan. Answered calls are.
The overview says the ad can show the business name, a tracking phone, a city, hours, photos, a short bio, and reviews. Reviews and ratings says those reviews are managed in Google Business Profile, not in the Local Services account, and that the star rating and the review count affect ranking. The review link for an office lives on that profile. How to ask for reviews is in review requests across offices.
Budgets and bidding
How leads work says you set an average weekly budget from the average number of leads you want in a week. You can spend more than that weekly amount in a given week. You will not spend more than the monthly max. The monthly max is the average weekly budget times the average number of weeks in a month. After the monthly max, the ad does not show for the rest of the month unless you change the budget.
Lead prices vary by location, job type, lead type, and bid mode. Each charged lead counts toward the budget. Do not copy a rate from another market onto Oak Park.
Treat each office the way you already split Search budgets: its own amount, written down, with the office slug on the spend. The worksheet is in Google Ads budgets and call attribution. Local Services spend is a separate weekly budget on the provider account. It is not the shared Search budget.
The move into Google Ads
The transition page says existing Local Services campaigns are being migrated into Google Ads as a Performance Max campaign type with pay-per-lead goals. Ads still show on Google Search and Google Maps. The campaign stays keywordless. Targeting still comes from the categories and areas you set. You still pay for valid leads rather than for clicks.
The first phase the page names is August 2026, for select home and storefront advertisers in the United States. The named work is plumbing, HVAC, electrical, appliance repair, house cleaning, lawn care, roofing, pest control, and moving. Late 2026 expands to broader groups, including service-area businesses without a storefront and accounts with custom bidding or booking. In 2027, non-U.S. accounts and remaining categories that were not migrated in 2026 move. Read the notice on your own account.
The account administrator gets an email 14 days before that account's migration date, a banner in the dashboard, and a reminder 7 days after the first email. Google says many ads start soon after the move, and to allow up to two weeks for the process to finish. You cannot create a new pay-per-lead campaign inside Google Ads yet. A new office still starts from the Local Services signup.
Performance reports do not carry over. Download them when the redirection page offers the file, or take screenshots if you need the history before the move. Past lead records do transfer to the Leads page in Google Ads. The old Local Services dashboard is not available after the migration day.
Business name, address, and hours sync one way from the Business Profile into Google Ads. Edit them on the profile. A large change to the name, the storefront address, or the primary category can pause the campaign for a review that the page says typically takes 24 to 48 hours. Photos and service areas are filled in from the profile and can then be edited for the ads on their own.
The weekly budget is divided by 7 to become the average daily budget. Monthly spend is capped at that daily amount times 30.4. Manual bidding, including a maximum cost per lead you set by hand, is being deprecated. A target set per industry on one campaign is replaced by one campaign-level target. Separate campaigns are how you keep separate bid rules.
Lead quality and budgets says manual lead disputes are no longer supported on this campaign type, and that invalid leads such as spam or duplicates are filtered. The health care credit exclusion still applies, so do not plan on a dental lead being credited.
What to count
View reports shows charged leads, the amount charged, and a split by call, message, and booking. You can filter category searches and direct business searches. For a dental office, read the call rows. Message and booking leads are not available for health care, so those columns are not the plan.
Record the count as a Local Services lead, next to Search leads, with the same office slug used on the rest of the report. The slug list is in the per-office marketing report. For calls, forms, and bookings in Analytics, see GA4 without patient details.
The reports page lets you mark a lead booked and add a job type and a customer name. It says those details are visible only to you. Leave the name, the caller's number, and any clinical note out of the group sheet and out of Analytics. A manager account can pull lead and cost data for many accounts. The export still uses the office slug, not a patient.
Who owns which edit
The group holds the accounts. A vendor can have a seat. The vendor is not the owner of record.
| Role | What they change | What you can open |
|---|---|---|
| Group owner | The manager account, billing, and who has a seat on each provider account. | The group can open the manager account and the payments profile. A vendor is a user with an access level, not the owner. |
| Operations | Hours on each Business Profile, and who answers the phone at that office. | Posted hours match the profile. A named role covers business hours, including a call that rings past 20 seconds. |
| Local SEO | The Business Profile matched to that office's provider account, and help with the verification steps. | The profile on the dashboard is that office. The person completing the checks is an owner or manager of that profile. |
| Paid media lead | The average weekly budget, the service area, the bid mode, and the lead review for that office. | Each office has its own budget and its own included cities or ZIPs. Overlap with another office is written down or removed. |
| Analytics | The office slug on Local Services lead counts in the group report. | The row uses the same slug as the rest of the report. It has no patient name, phone number, or clinical note. |
Questions for an agency
Ask these before a proposal or a renewal.
| Question | A useful answer names | Ask a follow-up if you hear |
|---|---|---|
| 1. Who owns the manager account, and what seat does the agency have? | The group owns the manager account and the billing. The agency has a named access level the group can change or remove. | The agency is the only admin, or the group cannot open billing. |
| 2. Is there one provider account per office? | One account per office, matched to that office's Business Profile, with that office's verification started in the dashboard. | One account covers Oak Park and Pine Hill, or two offices share one profile. |
| 3. How are service areas split when offices are near each other? | Each office includes the cities or ZIPs it can serve. Any shared ZIP is written down, because only the highest ranking ad shows for that area. | Every office targets the same ZIPs, or nobody can open the service-area list. |
| 4. Who answers, and what happens to a missed call during business hours? | A named role answers during the hours on that office's Business Profile. The team knows a missed call can count when the caller stays on the line for more than 20 seconds. | Nobody owns missed calls, or the plan assumes a dental lead will be credited. |
| 5. What budget and bid mode does each office use? | An average weekly budget per office, and a bid mode. Lead prices vary by location and job type. The monthly max is that weekly amount times the average number of weeks in a month. | One cost per lead promised for every office, or a guarantee of where the ad will show. |
| 6. What is saved before the account moves into Google Ads? | Historical performance reports exported or screenshotted, because they do not carry over. Name, address, and hours stay edited on the Business Profile. Manual bidding is being deprecated. | No export plan, or a claim that the old performance reports will be waiting in Google Ads. |
Red flags
Read a proposal for these patterns before you sign.
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1. One provider account for several offices.
Verification, the Business Profile match, the service area, and the budget sit on the account. Bulk creation makes one account per complete row. Oak Park and Pine Hill need two rows.
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2. Overlapping service areas with no written reason.
When locations serve the same area, Google shows only the highest ranking ad. If Oak Park and Pine Hill include the same ZIP, one ad is hidden. Write that down, or take the ZIP off one office.
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3. A promise of placement, or of credits for unwanted dental leads.
Rank is an auction. Lead credits are not available for health care verticals. A promise that a bad dental lead will be credited does not match those pages.
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4. The agency owns the manager account.
The group should hold the manager account and the billing. A vendor can have a seat. Consolidated monthly billing needs the manager link, and the group should be able to open that link.
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5. No plan to export reports before the move.
Performance reports do not carry over into Google Ads. Save them before the migration date on the account. Past lead history does transfer. Keep patient names and numbers out of the group report.
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6. Nobody owns missed calls.
A missed call during business hours can be charged when the caller stays for more than 20 seconds. Missed calls may also hurt responsiveness, which is a ranking input. Name who answers at each office.
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7. Broad search is flipped with no note.
The setting starts on, so the ad can serve for a category search such as "dentist near me." Turning it off drops those queries, and Google says leads may decrease. On an account with more than one industry, off applies to every industry.
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8. Verification is done by someone who cannot open the profile.
The person completing the checks has to be an owner or manager of the matching Business Profile. For a US health care office, NPI verification is a prerequisite. Follow the steps in the dashboard.
Checklist
Twelve checks before an office starts spending on Local Services Ads.
Local Services Ads checklist
12 items
What DDS Web Solutions builds
DDS Web Solutions builds practice websites. Our team has been building websites since 2014, and we have served 100+ practices. The offices are in Sacramento and San Mateo. Our products include Smyly, SmileTrak, and ToothRank. We can help a group set up one provider account per office with a service area that matches each office. We do not promise leads or ad positions. For group planning, see DSO and multi-location marketing. For hiring a firm, see how to choose a DSO dental marketing company.
Sources
- Local Services Ads Help: Getting started with Local Services Ads
- Local Services Ads Help: Local Services Ads overview
- Local Services Ads Help: About ad rankings
- Local Services Ads Help: How leads work
- Local Services Ads Help: About Automated Local Services Ads lead credits
- Local Services Ads Help: Understand the screening and verification process
- Local Services Ads Help: About Local Services Ads bulk account creation
- Local Services Ads Help: Manage access to your Local Services Ads account
- Google Ads Help: About Google Ads manager accounts
- Local Services Ads Help: Edit your industries, service areas, and job types
- Local Services Ads Help: Reviews and Ratings on Local Services Ads
- Google Ads Help: Local Services Ads transition to Performance Max campaigns with pay-per-lead goals
- Google Ads Help: Lead quality and budgets for campaigns with pay-per-lead goals
- Local Services Ads Help: View reports on Local Services Ads
- Local Services Ads Help: Manage leads and jobs