GLO MOUTHGUARD - PINK (DZ) *I

Basic Information

• Brand Name: GLO MOUTHGUARD - PINK (DZ) *I
• Primary DI: D7751910211
• Version / Model: 191-021
• Catalog Number: 191-021
• Company Name: Great Lakes Dental Technologies, Ltd.
• Labeler DUNS: 041854332
• Distribution Status: In Commercial Distribution
• Device Count in Pkg: 1
• Record Status: Published
• Publish Date: 2016-05-18
• Public Version: 7
• Public Version Date: 2021-02-02
• Public Version Status: Update
• Public Device Record Key: 3fe6ea13-0368-418c-b69e-ad878ea3ae51

Device Description

GLO MOUTHGUARD - PINK (DZ) *I

Device Characteristics

• Single Use: Yes
• Prescription Use (Rx): Yes
• Over the Counter (OTC): No
• Kit: No
• Combination Product: No
• HCT/P: No
• Contains NRL: No
• Not Made with NRL: No
• MRI Safety: Labeling does not contain MRI Safety Information
• Direct Marking Exempt: No
• PM Exempt: Yes
• Has Serial Number: No
• Has Lot/Batch Number: No
• Has Manufacturing Date: No
• Has Expiration Date: No
• Has Donation ID: No

Sterilization

• Is Sterile: No
• Sterilization Prior Use: No

Product Codes

Code	Name	Medical Specialty	Regulation #	Device Class
DYJ	Retainer, Screw Expansion, Orthodontic	Dental	872.5410	1

GMDN Terms

Code	Name	Definition	Implantable	Status
38621	Mouthguard, reusable	A prefabricated oral device designed to protect the teeth, bones, and tissues of the mouth from damage due to impact/trauma typically during endoscopic diagnostic procedures, contact sports, and/or to prevent teeth grinding/clenching (bruxism). It is made of standard, preformed materials or items for adaptation to/direct insertion into the mouth; some types are referred to as nightguards or bite raising appliances. This is a reusable device.	No	Active

Identifiers

Type	ID	Issuing Agency	Package Type	Qty per Pkg	Pkg Status	Pkg Discontinue Date
Primary	D7751910211	HIBCC

Customer Contacts

• Phone: [phone]
• Email: [email protected]