PROVISA 4815-783

GUDID 00366975001054

PROVISA +10 TEMP C&B 50ML A1

BENCO DENTAL SUPPLY CO.

Dental crown/bridge resin, temporary

• Primary Device ID: 00366975001054
• NIH Device Record Key: c26c7e8d-4e97-4d5f-aa5c-fcccd273cc1f
• Commercial Distribution Status: In Commercial Distribution
• Brand Name: PROVISA
• Version Model Number: 4815-783
• Catalog Number: 4815-783
• Company DUNS: 015108087
• Company Name: BENCO DENTAL SUPPLY CO.
• Device Count: 1
• DM Exempt: false
• Pre-market Exempt: false
• MRI Safety Status: Labeling does not contain MRI Safety Information
• Human Cell/Tissue Product: false
• Device Kit: false
• Device Combination Product: false
• Single Use: false
• Lot Batch: true
• Serial Number: false
• Manufacturing Date: true
• Expiration Date: true
• Donation Id Number: false
• Contains Natural Rubber Latex: false
• Labeled No Natural Rubber Latex: false
• RX Perscription: true
• OTC Over-The-Counter: false

Customer Support Contacts

• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com
• Phone: 570-602-6924
• Email: jsoroka@benco.com

Operating and Storage Conditions

• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit
• Storage Environment Temperature: Between 45 Degrees Fahrenheit and 74 Degrees Fahrenheit

Device Identifiers

Device Issuing Agency	Device ID
GS1	00366975001054 [Primary]

FDA Product Code

• EBG: Crown And Bridge, Temporary, Resin

Sterilization

• Steralize Prior To Use: false
• Device Is Sterile: false

Device Entry Metadata

• Public Version Status: Update
• Device Record Status: Published
• Public Version Number: 2
• Public Version Date: 2018-03-29
• Device Publish Date: 2016-09-24

On-Brand Devices [PROVISA]

• 00366975025951: Provisa™ C&B 10:1 Mix Tip Refill Pack of 25
• 00366975025869: Provisa™ Temporary Cement Mixing Tips Pack of 20
• 00366975001139: Provisa Temp Cement Syr 2x5ml
• 00366975001122: Provisa Temp Cement Syr 1x5ml
• 00366975001108: PROVISA +10 TEMP C&B 50ML BLCH
• 00366975001092: PROVISA +10 TEMP C&B 50ML B1
• 00366975001085: PROVISA +10 TEMP C&B 50ML A3.5
• 00366975001078: PROVISA +10 TEMP C&B 50ML A3
• 00366975001061: PROVISA +10 TEMP C&B 50ML A2
• 00366975001054: PROVISA +10 TEMP C&B 50ML A1
• D74443751880: PROVISA+ C&B TEMP 4:1 BL KT
• D74443751600: PROVISA+ C&B TEMP 4:1 B1 KT
• D74443751510: PROVISA+ C&B TEMP 4:1 A3.5 KT
• D74443751420: PROVISA+ C&B TEMP 4:1 A3 KT
• D74443751330: PROVISA+ C&B TEMP 4:1 A2 KT
• D74443751150: PROVISA+ C&B TEMP 4:1 A1 KT