PROVISA

GUDID 00366975001122

Dental composite resin

Primary Device ID	00366975001122
NIH Device Record Key	c9c5acb4-6fda-4a57-ad89-8a6da2d33ad5
Commercial Distribution Status	In Commercial Distribution
Brand Name	PROVISA
Version Model Number	4607-267
Company DUNS	015108087
Company Name	BENCO DENTAL SUPPLY CO.
Device Count	1
DM Exempt	false
Pre-market Exempt	true
MRI Safety Status	Labeling does not contain MRI Safety Information
Human Cell/Tissue Product	false
Device Kit	false
Device Combination Product	false
Single Use	true
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

Device Issuing Agency	Device ID
GS1	00366975001122 [Primary]

EMA	Cement, Dental

Steralize Prior To Use	false
Device Is Sterile	false

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

Mark Image Registration \| Serial	Company Trademark Application Date
PROVISA 86151555 4651722 Live/Registered	Milford Holding Company 2013-12-23
PROVISA 74312309 1871826 Dead/Cancelled	LANNER GROUP LIMITED 1992-09-09