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U.S. Department of Health and Human Services

510(k) Premarket Notification
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Device Classification Name Pick, Massaging
510(k) Number K860779
Device Name ULTRAPROX, INTERPROXIMAL TOOTHBRUSH
Applicant
William J. Forni, D.D.S.
4655 Hoen Ave.
Santa Rosa,  CA  95405
Correspondent
William J. Forni, D.D.S.
4655 Hoen Ave.
Santa Rosa,  CA  95405
Regulation Number872.6650
Classification Product Code
JET  
Date Received03/03/1986
Decision Date 04/02/1986
Decision Substantially Equivalent (SESE)
Regulation Medical Specialty Dental
510k Review Panel Dental
Type Traditional
Reviewed by Third Party No
Combination Product No
Predetermined Change
Control Plan Authorized		 No
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